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Shank vessel injuries: the forgotten vascular injuries
E Stuebing1, H Lieberman1, T Vu1
1Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
Insights
Vascular injuries to shank vessels, like the anterior and posterior tibial arteries, are common in trauma. Modern management has significantly reduced amputation rates for these critical limb injuries.
Area of Science:
- Vascular Surgery
- Trauma Management
- Orthopedic Surgery
Background:
- Popliteal and shank vessel injuries occur from blunt and penetrating trauma.
- Management strategies have evolved, but limb loss and morbidity remain significant concerns.
- These injuries represent a notable portion of combat and civilian vascular trauma cases.
Purpose of the Study:
- To review the current understanding and management of vascular injuries in the popliteal and shank vessels.
- To highlight advancements in diagnosis and treatment leading to improved outcomes.
Main Methods:
- Diagnosis relies on physical examination and Ankle-Brachial Index (ABI) measurement for triage.
- Despite technological progress, surgical exposure and intervention in these areas remain challenging.
Main Results:
- Modern advances in vascular trauma care have led to a substantial decrease in amputation rates.
- Effective triage and surgical techniques are crucial for limb salvage.
Conclusions:
- Shank vessel injuries continue to be a significant challenge in trauma surgery.
- Advances in treatment have dramatically improved outcomes, reducing amputation rates.
Introduction:
Vascular injuries in branch vessels of the popliteal artery, such as the tibioperoneal trunk, and shank vessels, such as anterior, posterior tibial, and peroneal vessels, occur in both blunt and penetrating trauma. Their management has evolved significantly in the past few decades. While their incidence is variable, limb loss and morbidity remain significant.
Material And Methods:
Physical examination, along with measuring an Ankle-Brachial Index (ABI), is still sometimes all that is required for diagnosis and can expeditiously triage those that require urgent operation. Despite our technological advancements and newer algorithms for lower extremity vascular trauma, operative intervention and exposure still remain difficult and pose a great challenge for surgeons that normally do not operate on this area.
Conclusions:
Shank vessel injuries still comprise a significant proportion of combat and civilian vascular injuries, and modern advances have led to a dramatic decrease in amputation rates.
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