Vascular Reconstruction and Limb Loss in Military Tibial Artery Injuries

Selective operative management of injuries to the tibial arteries is controversial, with necessity revascularization in face multiple debated. Tibial artery are frequently encountered military trauma, but practices and outcomes poorly defined. We aimed investigate associations between number injured vessels reconstruction limb loss rates casualties arterial trauma. A US database lower extremity vascular from Iraq Afghanistan (2004-2012) was queried for limbs sustaining at least one injury. Injury intervention characteristics were analyzed by (one, T1; two, T2; three, T3). included 221 (194 T1, 22 T2, 5 The proportions concomitant venous, orthopedic, nerve, or proximal similar groups. Arterial (vs ligation) performed 29% 63% universally T3 (P < .001) (Figure). via vein graft localized repair) 62% 54% 80% = .59). received greater blood transfusion volume .02) fasciotomy used 34% T1 14% P .05). Amputation 23% 26% 60% .16), amputation not significantly predicted ligation .08) T2 .34) limbs. Infection more common (80%) than (25%) (32%, .02), other complication similar. In this series injuries, an increasing associated use reconstruction. Limbs all three had high complex eventual amputation. Limb one- two-vessel suggesting that selective these cases advisable.