Management of major arterial injuries of the limbs in 166 cases.

The charts of 166 patients with major arterial injuries (175 arterial repairs) inflicted during periods of peace and war time were reviewed. One hundred and sixty-seven (95%) of the arteries repaired remained patent. Nine patients had limbs which developed ischemic contracture. Nine patients required amputations. Follow-up data was obtained from seventy-five patients with an average follow-up of five years and one month (six months to thirty years). Early diagnosis, prompt treatment including fasciotomies when indicated, complete debridement, appropriate coverage, meticulous surgical technique, and simultaneous treatment of concomitant injuries are all crucial factors in successful limb salvage. Major arterial injuries of the limb occur frequently in our patient population, especially in time of war. Successful treatment of major arterial injuries may be life-saving, as well as allowing limb salvage and restoration of limb function. The purpose of this study is to review our experience with repair of major arterial injuries.