Arterial lesions in osteoarticular trauma of the lower limbs

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Bilel Derbel
Daniela Mazzaccaro
Abdelkader Hfayedh
Jaleledine Ziadi
Rim Miri
Giovanni Nano
Ghedira Faker
Raouf Denguir

Abstract

OBJECTIVE: To evaluate in-hospital mortality and limb salvage of a series of patients presenting with arterial injury of the lower limbs complicating an osteoarticular trauma, and to determine any preoperative predictive factors of limb salvage.


METHODS: Data of consecutive patients treated between 01/2007 and 12/2017 were retrospectively analyzed. Primary outcomes were in-hospital mortality and limb salvage. Multivariate analysis was performed to assess any variable that could affect limb salvage. P values <0.05 were considered statistically significant.


RESULTS: The postoperative course, death occurred in 2 patients Lower limb amputation was performed in 13 cases (15.6%). The main factors predicting limb amputation were the timing of staged surgery, in particular when bone stabilization was performed first (P<0.001), and a delay Data concerning 74 patients with 83 traumatized lower limbs were analyzed. Most vascular lesions were located at the popliteal artery (47, 63.5%). Surgical bone stabilization was performed as a first step in 45 patients (60.8% of cases), followed by a delayed arterial repair. The median time to revascularization was 14.3 hours (range from 2 hours to 6 days). In 29 patients (39.2%) vascular repair and bone stabilization were performed simultaneously. During to limb revascularization longer than 6 hours (P<0.001). The location of injury at the popliteal artery (P=0.005), the presence of infection (P<0.001), and the severe ischemic signs at presentation (P=0.001) also were factors associated with amputation.


CONCLUSIONS: The timing of staged surgical repair and the revascularization delay were the main predictor factors of limb salvage.

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How to Cite
Derbel, Bilel, et al. “Arterial Lesions in Osteoarticular Trauma of the Lower Limbs”. Annali Italiani Di Chirurgia, vol. 90, no. 4, July 2019, pp. 364-70, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1529.
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