Abstract

Background: Recognition of the vascular injury is often obscured by the difficulties of examining the painful, swollen extremity that accompanies bone injury. More often than not, however, it is the failure to assess the status of the distal extremity or to appreciate the significance of a large hematoma, recurrent bleeding and distal ischemia that causes delay in recognition of arterial injury. The aim of this study was to evaluate the limb salvage percentage of lower limb trauma with respect to amputation rate.
Patients and methods: This prospective study involved 18 patients with lower limb vascular who conducted at Zagazig University Hospitals. All patients were subjected to clinical examination including general examination for vital signs and local examination to determine site and type of the vascular injury. Laboratory investigations are done including full laboratory tests and radiologic imaging (duplex or CTA). Follow up of patients depended on mangled extremity severity score, linjury severity score and the Gustillo Anderson classification for maximum 2 to 4 weeks postoperatively.
Results: Time interval from trauma to hospital admission was distributed as 7.113.32, major Mechanism of accident was RTA, ischemic limb founded in 77.8%, 66.7% had associated injury, 44.4% had nerve injury, the major type of vascular injury was SFA.  MESS was distributed as 5.05±1.89 and the majority 61.1% had ATA & PTA Pulse post-operative. Concerning the relation between outcome and other demographic and clinical characters, bad outcome significantly associated with higher MESS. There was a significant association between bad outcome and longer interval from trauma till hospital admission
Conclusion: Reduced amputation rates for traumatic lower limb arterial injuries have been achieved with improved revascularization and resuscitative techniques.