[Single injuries to distal leg arteries]

The appropriate treatment of an injury to a single arterial vessel of the calf is still a matter of discussion. Isolated injury of one of the calf arteries is generally not considered to cause severe ischemia of the leg. Other factors such as the degree of concomitant trauma to bones, nerves, veins and soft tissue, which may impair collateral circulation, seem to represent the real threat for the survival of the extremity. On the other hand, high numbers of amputations were reported after the Second World War following ligation of an injured single vessel of the calf. Concomitant injuries are poorly documented in these reports. Consequently a good physical examination as well as arteriography, duplex ultrasound scan and a high index of suspicion are mandatory to evaluate the impaired circulation of the calf and to prevent hasty ligation of a single vessel.