Arterial Injuries In Lower Extremity Trauma – Outcomes Of A Single Center Study

Abstract

Objectives: Femoropopliteal artery injury is a common and potentially life-threatening form of arterial injury in the lower extremities. Despite advancements in its management, there is still a considerable risk of amputation and death associated with these injuries.
Methods: We conducted a retrospective analysis on the patients who received treatment for lower limb trauma and concomitant arterial injury at a Level 1 Trauma Center and aimed to compare patient characteristics, injury severity scores, time to surgery, vascular repair methods, presence of fractures, and sequence of vascular and orthopedic repairs between groups: limb salvage vs amputation and survival vs death. We also aimed to identify factors contributing to amputation and death.
Results: Between January 2020 and June 2023, 21 patients, 71.4% male and 28.6% female patients were treated. 95.2% of the injuries were caused by blunt trauma, and the most commonly injured artery was the popliteal artery, in 61,9% of the cases. MESS scores were significantly higher in patients who died (p=0.012) and the presence of an exposed fracture was more common in patients who underwent amputation (p=0.004). 23,8% of patients were submitted to above knee amputation and a death rate of 19% was observed.
Discussion/Conclusion: When dealing with multiple injured limbs, the treatment approach and priorities are still under discussion, typically customized based on individual clinical situations. Our study underscores the significance of promptly performing vascular repair, reducing time delays, and taking into account bone and soft tissue injuries in the treatment strategy.