Management of major arterial injuries of limbs: a study of 166 cases.

Case records of 166 patients with 180 major arterial limb injuries inflicted between 1959 and 1991 were reviewed. A total of 167 (95.4%) repaired arteries initially remained patent. Nine patients developed ischaemic contracture of their limbs, which required amputation. Late follow-up of 6 months--30 years (mean 5 years) was obtained for 75 patients; 73 of these repairs remained patent. Early diagnosis, prompt treatment, complete débridement, appropriate coverage of the repaired vessels, fasciotomy when indicated and simultaneous treatment of concomitant injuries are crucial factors in successful limb salvage and in maintaining patency of the repaired vessels.