title: Lower extremity arterial injuries over a six-year period: outcomes, risk factors, and management.
abstract: OBJECTIVE
  Limb loss following lower extremity arterial injury is not uncommon and has serious implications on the patient's life and functionality. This retrospective study was performed to analyze the results of lower extremity arterial injuries and to identify the risk factors associated with amputation.
  
  
  METHODS
  Between 2002 and 2009, retrospectively collected data on 140 patients with 173 lower extremity arterial injuries were analyzed.
  
  
  RESULTS
  There were 133 males (95%) and 7 females (5%). The mechanism of injuries was gunshot wounds in 56.4% of cases, stab wounds in 30%, and blunt trauma in 13.4%. Associated injuries included vein injury in 45% of cases, nerve injury in 16.4%, and bone fracture in 31.4%. The most frequently injured artery was superficial femoral artery (31.2%). More than 1 artery was injured in 18.6% of patients. Surgery was carried out, with a limb salvage rate of 90.4% and a survival of 97.1%. Amputation was performed in 75% of patients in whom only 1 artery was repaired, although all crural arteries were injured. Multivariate logistic regression analysis showed that significant risk factors of outcome were below-knee multiple arterial injuries (odds ratio [OR] 6.62, P < 0.001), associated 2-bone fractures (OR 2.71, P = 0.003), development of compartment syndrome (OR 1.94, P = 0.042), and great soft tissue disruption (OR 1.74, P = 0.010).
  
  
  CONCLUSIONS
  Limb loss may be decreased by performing prophylactic fasciotomy more often and by repairing at least 2 crural arteries.
authors.affiliation: Cardiovascular Surgery Department, Dicle University Medicine Faculty, Diyarbakir, Turkey. aendertopal61@hotmail.com
authors.forename: Aşkin Ender
authors.initials: AE
authors.lastname: Topal
authors.forename: Mehmet Nesimi
authors.initials: MN
authors.lastname: Eren
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Celik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001158:Arteries / Q000293:injuries* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D023821:Limb Salvage; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D055815:Young Adult