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Outcomes Following Below Knee Arterial Trauma
Millicent Croman1, Tessa Lamberton1, Audrey Covington1
1Harbor-UCLA Medical Center, Department of Surgery, Torrance, CA, USA.
The American Surgeon
|May 13, 2023
Summary
Outcomes for below-knee vascular trauma show an 8% amputation rate. Management requires a multidisciplinary approach, as multiple injuries increase amputation risk, especially with failed bypass grafts.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Lower extremity vascular injuries significantly increase morbidity and risk of limb loss in trauma patients.
- Limited evidence exists on outcomes for tibial artery injuries.
- This study defines outcomes for traumatic vascular injuries below the knee.
Purpose of the Study:
- To define outcomes of traumatic vascular injury to vessels below the knee.
- To assess interventions, outcomes, and complications in patients with below-knee vascular injuries.
Main Methods:
- Retrospective review of patients with below-knee vascular injuries (November 2014 - June 2022).
- Utilized ICD-9 and ICD-10 codes at a Level 1 trauma center.
- Assessed interventions, outcomes, and complications.
Main Results:
- 76 patients identified; mean age 35.3 years, 88% male.
- Posterior tibial artery (40%) and anterior tibial artery (36%) were most commonly injured.
- Overall amputation rate was 8% (6/76), with 3 due to failed bypass grafts; all amputations associated with open fractures.
Conclusions:
- Management of below-knee vascular trauma necessitates a multidisciplinary approach.
- Reconstruction patients often have multiple vessel injuries, increasing graft failure risk.
- Extensive soft tissue injury, multi-vessel injuries, and failed bypass grafts elevate amputation risk.
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