Arterial Injuries In Lower Extremity Trauma - Outcomes Of A Single Center Study

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Orthopedic Surgery

Background:

• Femoropopliteal artery injuries pose significant risks of amputation and death.
• Despite advancements, optimal management strategies remain under discussion.

Purpose of the Study:

• To compare patient characteristics, injury severity, and repair sequences in limb salvage versus amputation and survival versus death.
• To identify factors contributing to amputation and death in lower extremity arterial injuries.

Main Methods:

• Retrospective analysis of 21 patients with lower limb trauma and arterial injury at a Level 1 Trauma Center.
• Comparison of patient data including injury severity scores, time to surgery, repair methods, and fracture presence.
• Analysis of vascular versus orthopedic repair sequencing.

Main Results:

• Blunt trauma caused 95.2% of injuries, with the popliteal artery most commonly affected (61.9%).
• Higher Injury Severity Scores (MESS) correlated with mortality (p=0.012).
• Exposed fractures were more frequent in amputated limbs (p=0.004), with 23.8% undergoing above-knee amputation and a 19% mortality rate.

Conclusions:

• Prompt vascular repair and reduced treatment delays are critical.
• Integrated management considering bone and soft tissue injuries is essential for optimizing outcomes.
• Treatment approaches should be individualized based on clinical scenarios for complex limb trauma.