Features And Treatment Of Traumatic Tibiofibula Fracture With Major Artery Injury

Objective To explore the clinical features and treatment of traumatic tibiofibula fracture with major artery injury. Methods A retrospective analysis was made on 16 cases of traumatic tibiofibula fracture with injury of major arteries including popliteal artery, anterior and posterior tibial arteries. Results 9 cases had injury in the popliteal artery (56.25%) , 4 in the anterior tibial artery (25.0%) , and 3 in both anterior and posterior tibial arteries (18.75%);End-to-end anastomosises were performed in 7 patients, embolectomies in 5, interposition of saphenous vein graft in 1 and polytetrafluoroethylene (PTFE) graft in 2 cases. One patient underwent a simple ligation of the anterior tibial artery because of multiple-injures;6 limbs were salvaged (salvaged group), while 10 cases underwent secondary amputations (amputated group). The MESS score of the amputated group was 6.20±1.03, and was significantly higher than that of the salvaged group (P<0.05). All pf the 10 cases in amputated group had signs such as diminished or no pulses, badly-matched color of skin. There wassignificant difference between the two groups iP<0.01);5 cases were diagnosed to have Compartment Syndrome before fixations and received fasciotomies, 3 of them had their limbs salvaged. Conclusions Artery injury may be critical and should be taken seriously throughout the treatment of patient with tibial fracture, especially with fracture of tibial plateau. 5P's (Pain> Pallor, Paresthesias> ParalysiSN Pulselessness) have clinical value for early diagnosis and prognosis of artery injuries.