Arterial injuries below the knee: fifty-one patients with 82 injuries.
Clinical features of tibial and peroneal artery injuries are characterized in a review of 51 patients with 82 injured arteries. Injuries were penetrating in 34 (67%) patients and blunt in 17 (33%). Physical findings suggested arterial injuries in 42 (82%) patients, but nine had no signs of vascular trauma. Nineteen patients with no palpable distal pulses had average preoperative delays of nearly 5 hours, suggesting a lack of appreciation for the morbid potential of these injuries. Operations included ligations of single-vessel injuries and arterial reconstructions in the 21 (41%) patients with two or more injured vessels. Amputations were necessary in eight (16%) patients. Limb loss was more frequent with blunt trauma (23%), shotgun wounds (33%), initial absent pulses (32%), and three injured vessels (60%). The frequency of limb loss with these injuries emphasizes the importance of early diagnosis, expedient operation, and thorough revascularization.
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D000792:Angiography; D001158:Arteries / Q000293:injuries / Q000601:surgery; D002648:Child; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007869:Leg Injuries / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged
D006493:Heparin