title: Limb salvage after delayed diagnosis for blunt traumatic infrapopliteal occlusion.
abstract: Infrapopliteal occlusion is uncommon after blunt trauma, and limb salvage after delayed diagnosis is even rarer. We present the case of a 56-year-old man who had complex lower leg orthopedic fractures along with a reportedly normal pulse examination with an 11-day diagnostic delay of limb-threatening ischemia requiring distal revascularization. This case illustrates an incidence of delayed infrapopliteal three-vessel occlusion with successful revascularization and subsequent endovascular management to maintain patency. We describe the workup and treatment of delayed infrapopliteal occlusion and a review of the current literature on this topic.
authors.affiliation: Department of Vascular Surgery, Madigan Army Medical Center, Tacoma, Wash 98431, USA. mwcausey@msn.com
authors.forename: Marlin Wayne
authors.initials: MW
authors.lastname: Causey
authors.forename: Morohunranti O
authors.initials: MO
authors.lastname: Oguntoye
authors.forename: Seth
authors.initials: S
authors.lastname: Miller
authors.forename: Charles
authors.initials: C
authors.lastname: Andersen
authors.forename: Niten
authors.initials: N
authors.lastname: Singh
mesh_terms: D000063:Accidents, Traffic; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D057210:Delayed Diagnosis; D005360:Fibula / Q000293:injuries / Q000601:surgery; D005592:Fracture Fixation; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012501:Saphenous Vein / Q000637:transplantation*; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013978:Tibial Fractures / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*