11 femoral fractures with vascular injury: good outcome with early vascular repair and internal fixation.
We reviewed 11 consecutive cases with combined femoral fracture and vascular injury presenting with acute ischemia. 6 cases had ischemia exceeding 8 hours and 4 of them developed massive muscle necrosis in the lower leg. 5 cases with ischemia less than 8 hours had no muscle necrosis. Vascular repair preceded fracture stabilization in 5 cases; there were no vascular complications during the subsequent fracture stabilization. 6 fractures treated with internal fixation had uneventful fracture-healing, whereas the 4 which were treated with external fixation needed later reoperations to obtain fracture-healing. We conclude that the limb must be reperfused within 6-8 hours. Vascular repair should be the first procedure, and fracture fixation by internal fixation is then preferred.
Braten
M
M
Department of Orthopedics, Univesity Hospital, Trondheim, Norway.
Helland
P
P
Myhre
H O
HO
Molster
A
A
Terjesen
T
T
D000293:Adolescent; D000328:Adult; D001808:Blood Vessels / Q000293:injuries; D005264:Femoral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005269:Femur / Q000098:blood supply*; D005593:Fracture Fixation, Internal; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009336:Necrosis; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures