Closed Limb Fractures With Compromised Vascularization: A Narrative Review

Area of Science:

• Orthopedic Surgery
• Traumatology
• Bone Healing Biology

Background:

• Vascular compromised fractures present significant healing challenges, including avascular necrosis and nonunion.
• These complications severely impair patient function and quality of life.

Purpose of the Study:

• To review the epidemiology and treatment options for common vascular compromised closed fractures.
• Focus on scaphoid, lunate, femoral neck, and talar fractures.

Main Methods:

• Literature review of epidemiological data and treatment modalities.
• Analysis of conservative and surgical interventions.
• Evaluation of factors influencing treatment decisions.

Main Results:

• Optimal treatment is multifactorial, considering fracture displacement, comminution, and patient-specific demands (age, bone quality, activity level).
• Conservative treatment involves immobilization; surgery is typically for displaced fractures or when conservative methods fail.
• Internal fixation with screws, plates, or K-wires is common, with bone grafting and salvage procedures reserved for severe cases.

Conclusions:

• Treatment strategies for vascular compromised fractures must be individualized.
• Early and appropriate intervention can mitigate complications and improve functional outcomes.
• Salvage procedures are a last resort due to permanent anatomical alteration.