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Fracture of Long Bones With Arterial Injury Due to Blunt Trauma Principles of Management

Roger F. Smith, MD; D. Emerick Szilagyi, MD; Joseph P. Elliott Jr., MD
Arch Surg. 1969;99(3):315-324. doi:10.1001/archsurg.1969.01340150023004.
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Blunt trauma severe enough to cause fracture of the long bones of the limb may seriously damage adjacent arteries either by direct or indirect force. Disruption or thrombosis of the traumatized artery usually ensues, and the viability of the extremity may be jeopardized. Reports from the literature indicate that in the management of this combination of injuries, diagnosis is frequently delayed until the opportunity to salvage the extremity is lost, or temporizing measures are utilized in the false hope that the vascular impairment does not represent arterial damage requiring prompt treatment.1-4 These errors will result in an excessively high amputation rate. When, however, arterial injury is recognized without undue delay as an accompaniment of the fracture and the proper operative approach is undertaken, the reported results have been more encouraging.5,6 Experience with the management of this complex problem is not easy to gain since the incidence of the


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