16-Sep-99 3:00 PM CST

Tibial Shaft Fractures With an Associated Infrapopliteal Arterial Injury: A Survey of Vascular Surgeons' Opinions on the Need for Vascular Repair

Journal of Orthapaedic Trauma Vol. 14, No. 3. pp.194-198, 1999

Authors: Mark R. Brinker, *M.Andrew Caines. Morris D. Kerstein, and, Marc·N. Elliott

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The literature addressing tibial shaft fractures associated with a vascular injury is difficult to interpret. As we have previously discussed (1). comparisons among published series from various centers are made difficult because of differences in definitions and treatment protocols. In their original series, Gustilo et al. (4) defined a Type III C injury as one in which a fracture is associated with an arterial injury 'requiring repair." As we have previously suggested (1). because the indications for vascular repair of the infrapopliteal vessels have been poorly delineated in the literature (and ate typically at the discretion of the attending vascular surgeon), the term "requiring repair" is subject to interpretation. To the best of our knowledge, no published articles have presented a clear, evidence-based treatment algorithm regarding the indications for operative

repair of infrapopliteal anerial injuries associated with a tibial shaft fracture.

The purpose of the current study was to determine whether or not there is general agreement among vascular surgeons as to the indications for operative repair of infrapopliteal arterial injuries associated with a tibial shaft fracture. For this investigation, we surveyed active members of the Society for Clinical Vascular Surgery to elicit their opinions on the need for vascular repair in a variety of clinical scenarios.

MATERIAlS AND METHODS
To assess current practice for revascularlzation of infrapopliteal arterial injuries associated with tibial shaft ...

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