Management of pediatric traumatic lower extremity vascular injuries

Pediatric lower extremity vascular injuries are challenging to manage and treat. Early recognition and a high index of suspicion is needed to ensure accurate diagnosis and timely interventions to prevent limb loss. These injuries present numerous technical challenges to the surgical multidisciplinary team, particularly in a very young patient. Technical challenges relate to small vessel size, vasospasm, and at times the lack of a suitable conduit for vascular reconstructions. The literature describing accepted clinical algorithms and techniques to manage these patients and their injuries are sparse. Moreover, there is significant variability in clinical specialties involved in their care.

A thorough literature review was performed on pediatric lower extremity traumatic injuries. Iatrogenic injuries were not included in this review. Expert opinion of those who routinely intervene on pediatric lower extremity traumatic injuries was also considered.

The goal of this review was to summarize different injury patterns and promote management strategies that have been successful among practitioners experienced in managing pediatric extremity vascular trauma.