Peripheral vascular injuries associated with falls from heights

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Orthopedic Surgery

Background:

• Peripheral vascular injuries (PVIs) are uncommon complications of falls from height.
• This study reviews a 15-year experience with PVIs in patients sustaining falls from at least 3 stories.

Observation:

• Ten PVIs were identified in 230 patients falling from height.
• Injuries included popliteal artery and vein disruptions, tibial arteriovenous fistula, subclavian artery pseudoaneurysm, radial artery transection, and medial circumflex artery laceration.
• All PVIs were associated with significant orthopedic trauma.

Findings:

• The most common injuries involved the popliteal artery and vein.
• A variety of arterial and venous injuries were observed, highlighting the diverse impact of high-energy trauma.
• The mechanism is multifactorial, but orthopedic injury is a consistent correlate.

Implications:

• Early diagnosis and intervention are critical for limb salvage.
• Management strategies should include minimizing ischemic time, performing completion arteriography, considering venous repair, and liberal fasciotomy.
• This case series underscores the importance of a high index of suspicion for PVIs in patients with severe orthopedic injuries from falls.