Penetrating injuries of the femoral artery

This is a retrospective study of 106 patients with penetrating injuries to the femoral artery. The cause of injury was gunshot in 82 per cent, stabbing in 13 per cent and pellets in 5 per cent. We believe that angiography is unnecessary in patients with 'hard' signs of vascular injury: 97 patients underwent immediate exploration with positive findings. The presence of 'soft' signs alone mandates angiography as five of 12 patients with suspected injury were saved a negative exploration. Proximity of injury was a poor predictor of arterial injury. There were four amputations. Ligation of the femoral vein is not reliably associated with amputation but it was an aggravating factor in the setting of severe arterial disruption and delay to surgery.