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Lower extremity vascular trauma: a comprehensive, aggressive approach.

E M Ashworth1, M C Dalsing, J L Glover

  • 1Department of Surgery, Indiana University Medical Center, Indianapolis 46202.

The Journal of Trauma
|March 1, 1988
PubMed
Summary

This study on lower extremity vascular trauma found that an aggressive surgical approach, prioritizing vascular repair, achieved a 96% limb salvage rate and enabled 84% of patients to ambulate independently.

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Area of Science:

  • Trauma Surgery
  • Vascular Surgery
  • Orthopedic Surgery

Background:

  • Lower extremity vascular trauma often results from penetrating injuries, predominantly affecting young males.
  • These injuries frequently involve associated soft-tissue damage, fractures, and nerve damage, complicating treatment and limb salvage.

Purpose of the Study:

  • To evaluate the outcomes of an aggressive surgical strategy for managing lower extremity vascular trauma.
  • To assess the efficacy of prioritizing vascular repair in conjunction with addressing associated injuries.

Main Methods:

  • Retrospective analysis of 25 patients (26 limbs) with lower extremity vascular trauma.
  • Surgical management focused on primary repair of arterial and venous injuries using autologous saphenous vein bypass when necessary.

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  • Concurrent management of soft-tissue injuries, fractures, and nerve damage, followed by fasciotomy and debridement as indicated.

    • Main Results:

    • A total of 37 vascular injuries (25 arterial, 12 venous) were treated.
    • Vascular repair was performed in 22 arterial and all major venous injuries, with 96% limb salvage achieved.
    • 84% of patients regained independent ambulation on the injured extremity.

    Conclusions:

    • An aggressive, limb-salvage-oriented approach to lower extremity vascular trauma is highly effective.
    • Prioritizing vascular repair, coupled with comprehensive management of associated injuries, leads to excellent functional outcomes.