Open tibial fractures with associated vascular injuries: prognosis for

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limb salvage. Lange RH. Bach AW. Hansen ST Jr. Johansen KH. Journal of Trauma. [JC:kaf] 25(3):203-8, 1985 Mar. Open tibial fractures complicated by limb-threatening vascular injuries present an infrequent but difficult management problem. Twenty-three cases were reviewed with an ultimate amputation rate of 61% (22% primary, 39% delayed). Crush injuries, segmental tibial fractures, and revascularization delays of greater than 6 hours were associated with a bad outcome. Guidelines for primary amputation (crushing injuries, delay in revascularization, segmental tibial fractures) are proposed and implications of limb salvage are reviewed.