Vascular injuries associated with limb fractures

The records of 46 patients with vascular injuries of the lower and upper limbs associated with bone fractures and managed in the authors' vascular and orthopaedics divisions were reviewed. All were young men, 26 with blunt and 20 with penetrating vascular injuries; 20 were treated by end to end anastomosis, 12 by vein interposition grafting, six by prosthetic graft, six by vein patches and lateral sutures and two by ligations. The limb salvage rate was 93 per cent. Three patients died (6.5 per cent) of severe associated injuries. Amputations were needed in three patients (6.5 per cent) with popliteal, tibial arteries and vein injuries. An aggressive approach to limb salvage is needed in these extensive injuries.