Arterial injuries with lower extremity fracture

Area of Science:

• Vascular surgery
• Trauma surgery
• Orthopedic surgery

Background:

• Lower extremity fractures frequently involve arterial injuries, posing a significant risk to limb viability.
• Management of these injuries requires prompt diagnosis and effective surgical intervention.

Purpose of the Study:

• To evaluate the outcomes of surgical repair for major arterial injuries associated with lower extremity fractures.
• To identify factors influencing limb salvage and functional results in these complex cases.

Main Methods:

• Retrospective review of 41 patients with lower extremity fractures and associated major arterial injuries.
• Analysis of repair techniques, diagnostic timelines, and patient outcomes, including amputation rates and long-term functional results.

Main Results:

• Femoral artery injuries demonstrated excellent repair outcomes with no amputations.
• Popliteal artery disruptions, particularly with diagnostic delays, resulted in an 18% amputation rate.
• Complete disruption of arteries distal to the popliteal trifurcation yielded only a 25% rate of long-term good results.

Conclusions:

• Prompt surgical repair of femoral artery injuries in lower extremity fractures leads to favorable outcomes.
• Delayed diagnosis and treatment of popliteal artery injuries significantly increase the likelihood of amputation.
• Arterial injuries distal to the popliteal trifurcation have a poor prognosis for limb salvage and long-term function.