Anterior Tibial to Dorsalis Pedis Bypass to Manage Acute Ischemia Attributed to Pilon Fracture
| Autor: | Efstratios Georgakarakos, Nikolaos Papatheodorou, Anthimos Keskinis, Georgios I Karaolanis, Paraskevas Georgoulas |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Vascular and Endovascular Surgery. 57:64-68 |
| ISSN: | 1938-9116 1538-5744 |
| DOI: | 10.1177/15385744221116844 |
| Popis: | Pilon fractures of the distal tibia are usually the result of a high-energy trauma and can affect seriously the arterial vasculature carrying an increased risk of amputation at the malleolar level or higher. Such cases represent a challenge for the orthopedic surgeons and a multidisciplinary approach is mandatory in order to salvage the threatened limb. We present an unusual case of a closed pilon fracture with injury of all tibial vessels leading to acute limb threatening ischemia. The patient was treated successfully with external fixation and a short tibial-pedal bypass with use of an autologous reversed saphenous vein graft. This example dictates how a distal leg fracture can be dramatic and that awareness of vascular examination coupled with high suspicion of vascular damage can be limb-saving. Multidisciplinary approach is warranted since the topology and complexity of the ankle lesions necessitate staged orthopedic reconstructions with tibio-distal bypass and appropriate skin coverage of the distal anastomosis. |
| Databáze: | OpenAIRE |
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