Acute ischemia of the lower limb after injury by gunshot: case report and review of literature
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : J. F. C. de Vasconcelos V. Martins D. Brandaکo M. Maia J. Ferreira S. Braga L. Rios H. Costa A. G. Vaz
- چاپ و سال / کشور: 2010
Description
Introduction Civilian and military vascular trauma has evolved dramatically. It is estimated that 80% of all cases of vascular injuries are due to peripheral vascular trauma, most involving the lower extremities. Arterial below-knee injuries by gunshot still remain a challenge, with an associated rate of amputation of 20–54%. Material and Methods This case reports a 48 year-old male patient who sustained a gunshot below his left knee. At hospital admission, loss of substance and hemorrhage at the medial and lateral faces of the upper third of his left leg were present with signs of distal ischemia. Arteriography revealed infra-popliteal arterial lesions of the three arterial axes. Two reversed great saphenous vein interposition grafts were performed into the anterior and posterior tibial arteries with immediate revascularization of the left leg and foot. Later, soft tissue reconstruction was accomplished by a split-thickness skin graft. Results At the fifth month of follow-up, the left leg and foot were viable with good healing, without limitations and with controlled pain. Posterior tibial and dorsalis pedis pulses were palpable. Conclusion This case report shows the importance of an adequate team approach for treatment of a gunshot extremity injury with vascular lesion. The authors want to highlight the scientific background evidence and the value of comparing worldwide civilian trauma center outcomes, mostly reported previously from the military field
Eur J Trauma Emerg Surg (2011) 37:53–59 DOI 10.1007/s00068-010-0035-8 Received: 10 January 2010 / Accepted: 6 June 2010 / Published online: 10 July 2010
