Lower Extremity Vascular Trauma

This chapter covers the presentation, workup, and open surgical management of vascular injuries to the lower extremity from the femoral to the tibial level. Arterial injury and reconstruction are the primary focus but venous injury is covered in the context of limb salvage. A new classification system for the investigation of extremity vascular injuries is presented, with injured limbs divided into those presenting with ischemic or hemorrhagic signs of vascular injury. Recommendations are made for the preoperative imaging workup of limbs with these signs and operative planning is discussed. General techniques for open surgical vascular repair are presented, and open repair tips at specific arterial levels are described.