Management of lower limb vascular injuries

Primary amputation in vascular trauma should be rare in the absence of prolonged ischemia, massive soft-tissue loss, and multiple fractures. Repair of the artery and vein, soft-tissue coverage, and rigid skeletal fixation is associated with an excellent limb salvage rate. Fasciotomy should be performed in cases with compartmental syndrome, and in complex injuries the use of temporary intravascular shunts is recommended for better overall patient management.