Choice of lower extremity bone-vascular injuries surgical approach

Introduction. The analysis of 119 treated patients with open associated injuries of lower extremities has been done and 72 (60.5%) of them had bone-vascular traumas. Instrumental methods of examination of blood circulation degree consisted of pulseoximetry, X-ray contrast angiography, colour duplex scanning. Materials and methods. On 34 (47.2%) of 72 patients restorative-reconstructive operations, including the stages of osteosynthesis and revascularization of ischemic lower limb, were performed. Osteosynthesis was mostly frequently performed with the use of Ilizarov apparatus (38.9%) that made further observation and aftercare of the wound easier. End-to-end anastomosis was the main method of blood supply restoration (57.1%). If there was a considerable vascular defect, its autovascular replacement was made in 8 (22.9%) cases. Results. In 57 (79.2%) cases primary healing was observed. 29 (85.3%) of 34 patients who were performed restorative-reconstructive operations on had an adequate blood circulation restoration. Conclusions. Timely blood circulation restoration is the main condition for saving the extremity. The choice of osteosynthesis method must be decided by the character of bones and soft tissues injuries and the possibility of performing vascular reconstruction. The kind of operation must be chosen with no risk on the patient’s life.