Open tibial fractures with associated vascular injuries: prognosis for limb salvage.
Open tibial fractures complicated by limb-threatening vascular injuries present an infrequent but difficult management problem. Twenty-three cases were reviewed with an ultimate amputation rate of 61% (22% primary, 39% delayed). Crush injuries, segmental tibial fractures, and revascularization delays of greater than 6 hours were associated with a bad outcome. Guidelines for primary amputation (crushing injuries, delay in revascularization, segmental tibial fractures) are proposed and implications of limb salvage are reviewed.
D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001808:Blood Vessels / Q000293:injuries*; D005260:Female; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013978:Tibial Fractures / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D014656:Vascular Surgical Procedures; D014680:Veins / Q000637:transplantation; D014948:Wounds, Gunshot / Q000601:surgery