Management of the compromised lower extremity

Musculoskeletal injury associated with vascular compromise is a limb-threatening situation. When these injuries are associated with open fractures, the risk of limb loss is increased. In the case of an open fracture of the tibia associated with vascular compromise distal to the popliteal artery trifurcation, limb salvage is rarely indicated. Attempts at limb salvage in open tibial fractures are associated with a high risk of complication, prolonged recovery and poor function. Early amputation is more effective than delayed amputation.