- See:
-
Vascular Trauma Associated w/ Fractures
(main dissucssion);
-
Technique of Microanatomosis:
- Discusion:
-
anterior tibial artery occlusion:
- most common site of vascular injury;
- occlusion occurs as anterior tibial artery passes from behind thru interosseous membrane;
- occlusion may cause loss of
anterior compartment muscles, even if posterior tibial
artery remains patent;
-
compartment syndrome of anterior compartment is common even if diastolic blood
pressure is normal;
- lower leg usually can survive loss of either
peroneal arteryor
posterior tibial artery;
- it is much less common for posterior tibial artery to be injured w/ frxs of tibia;
- however, injury to this artery may occur w/
compartment syndromes esp, when an inadequate
fasciotomy is performed (one that does not specifically adress the
deep compartment;
- Exam:
- presence of dorsalis pedis pulse does not r/o injury to ATA, since
there may be retrograde blood flow from posterior tibial artery;
- blood is shunted from the posterior tibial artery to the peroneal
artery and then to the dorsalis pedis pulse;
- while pulses are usually present in compartment syndromes, the absence of a pulse (eg. from
associated fracture or trauma) raises the probability that a compartment syndrome could occur;
- for instance loss of the anterior tibial artery following a tibial fracture, places
the anterior compartment at high risk for compartment syndrome;
The Severely Traumatized Lower Limb: Reconstruction versus
Amputation--Symposium: Vascular Injury Associated With Fracture-Dislocations of the Lower Extremity.
The Severely Traumatized Lower Limb: Reconstruction versus
Amputation--Symposium: Limb Reconstruction versus Amputation Decision
Making in Massive Lower Extremity Trauma.
