Fractures of the limbs complicated by ischaemia due to lesions of the major vessels.

The authors present their case material of 68 patients who had substained fractures of the limbs complicated by arterial lesions. Orthopaedic and vascular surgery should be performed within the shortest possible period of time, preferably within 12 hours of injury, and in certain severe arterial injuries within 4 hours. Osteosynthesis was performed in all cases prior to the arterial repair; in the authors' opinion this brief prolongation of the period of ischaemia has no effect on the general outcome of treatment. In the light of the results obtained, they believe that osteosynthesis should be performed with intramedullary nails in preference to plates. They found that the least satisfactory results were obtained in fractures of the lower two thirds of the tibia and fibula with lesions of the tibial arteries which at this level show characteristics typical of terminal arteries.