Treatment of vascular injuries associated with limb fractures

The goal of therapy in all patients with combined orthopaedic and vascular injuries of the extremities is salvage of a functional limb. In this study, we have evaluated our experience with a subset of patients who had a combination of vascular injury and limb fracture. The records of 192 patients wi...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2005-09, Vol.87 (5), p.348-352
Main Authors: Cakir, Omer, Subasi, Mehmet, Erdem, Kemalettin, Eren, Nesimi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Arm - blood supply
Arm Injuries - complications
Arm Injuries - diagnostic imaging
Arm Injuries - surgery
Arteries - injuries
Child, Preschool
Female
Fractures, Bone - complications
Fractures, Bone - diagnostic imaging
Fractures, Bone - surgery
Humans
Leg - blood supply
Leg Injuries - complications
Leg Injuries - diagnostic imaging
Leg Injuries - surgery
Male
Middle Aged
Radiography
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Summary:The goal of therapy in all patients with combined orthopaedic and vascular injuries of the extremities is salvage of a functional limb. In this study, we have evaluated our experience with a subset of patients who had a combination of vascular injury and limb fracture. The records of 192 patients with vascular injuries of the lower and upper limbs associated with bone fractures were reviewed. Of these, 168 were males and 24 were females; the mean age was 26 years. The mechanism of injury was a penetrating wound in 97 (51%) patients and blunt trauma in 95 (49%) patients. Injured vessels included 6 subclavian/axillary, 39 brachial, 14 radial/ulnar, 11 radial, 8 ulnar, 36 femoral, 43 popliteal, 35 tibial arteries. Saphenous vein graft was the most common conduit of choice in arterial repair (55%). Amputations were needed for 20 patients. The limb salvage rate was 88%. Three patients died. This study established that delay in surgery, blunt trauma and extensive soft tissue defect in combined orthopaedic and vascular injuries are associated with increased risk of amputation.
ISSN:0035-8843
1478-7083
DOI:10.1308/003588405X51146