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Original ArticleOpen Access
Arterial Injuries of the Lower Extremity from Blunt Trauma
Sriussadaporn S 
Thirty patients with 33 arterial injuries from blunt trauma of the lower extremity at Chulalongkorn
Hospital, Bangkok, Thailand from January 1989 to December 1995 were reviewed. Eight
patients (26.6%) were in shock on arrival. Twenty four (80%) presented with signs of ischemia. Twenty
six (86.7%) had asociated fractures and/or dislocations, 14 of them were compound fractures. Nine
(30%) had associated injuries at other parts of the body. Ten (33.3%) underwent preoperative angiography.
The preoperative time ranged from I to 72 hours, median 4 hours. One patient who had intimal
tear of the popliteal artery and was successfully treated conservatively. Popliteal artery was the
most common injured artery; followed by common femoral, superficial femoral, and anterior tibial
artery. Most arterial injuries were repaired by using reversed saphenous vein grafts. Associated
venous injuries were repaired in 5 patients. Fracture fixation was performed in 18 patients; 8 of them
were performed before arterial repair and 10 were performed after arterial repair. No intravascular
shunt was inserted in this study. Fasciotomy was performed in 15 patients. Five patients had limb
amputation (16.7%). Univariate analysis by Chi Square test revealed that associated venous
injuries, severe soft tissue injuries, and fasciotomy were statistically significant factors associated
with amputation. One patient who had external iliac artery injury died from severe head injury in
spite of a successful arterial repair (mortality rate 3.3% ).
Hospital, Bangkok, Thailand from January 1989 to December 1995 were reviewed. Eight
patients (26.6%) were in shock on arrival. Twenty four (80%) presented with signs of ischemia. Twenty
six (86.7%) had asociated fractures and/or dislocations, 14 of them were compound fractures. Nine
(30%) had associated injuries at other parts of the body. Ten (33.3%) underwent preoperative angiography.
The preoperative time ranged from I to 72 hours, median 4 hours. One patient who had intimal
tear of the popliteal artery and was successfully treated conservatively. Popliteal artery was the
most common injured artery; followed by common femoral, superficial femoral, and anterior tibial
artery. Most arterial injuries were repaired by using reversed saphenous vein grafts. Associated
venous injuries were repaired in 5 patients. Fracture fixation was performed in 18 patients; 8 of them
were performed before arterial repair and 10 were performed after arterial repair. No intravascular
shunt was inserted in this study. Fasciotomy was performed in 15 patients. Five patients had limb
amputation (16.7%). Univariate analysis by Chi Square test revealed that associated venous
injuries, severe soft tissue injuries, and fasciotomy were statistically significant factors associated
with amputation. One patient who had external iliac artery injury died from severe head injury in
spite of a successful arterial repair (mortality rate 3.3% ).
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