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Tue Nov 29 21:26:48 GMT 2005

Actually Eric you made the main site:

http://www.trauma.org/vascular/vascskeletal.html

See also Peripheral Vascular Trauma diagnosis:
http://www.trauma.org/vascular/PVTdiag.html

Karim

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of docrickfry at aol.com
Sent: 29 November 2005 15:05
To: trauma-list at trauma.org
Subject: Re: Fx Femur

I have posted on Karim's trauma.org wikipedia website an annotated algorithm, narrative and references regarding the appropriate
diagnostic and therapeutic steps for vascular trauma in this setting of complex skeletal extremity injury. ERF 

-----Original Message-----
From: Felix Albers <felixalbers at terra.com.br>
To: Trauma & Critical Care mailing list <trauma-list at trauma.org>
Sent: Tue, 29 Nov 2005 11:47:12 -0200
Subject: Fx Femur

Hi folks,

we had this case last week. a 55 year old man was struck by a van. Came to our 
ED 7 hours after the incident. Only identifiable injury was a fractured right 
femur (closed) with important edema, with diminished but simetrical peripheral 
pulses, consistent with the shock state (first inaudible, after ressuscitation 
60/30). This patient was not considered to have important vascular injury, and 
treatment was skeletal traction and ICU support. On the next day in the ICU he 
developed compartment syndrome and fasciotomy was performed. Still on the same 
day edema progressed to the lower leg and fasciotomy was performed there too. 
Persistent shock, rabdomiolysis, ARF, and sepsis from and infected leg occured. 
The leg was amputated but the patient died 9 days after the accident.

We will be discussing this case on 01/12/05. To me it looks like there was 
indication for arteriography on arrival. What do you think? This is one of the 
points I want to make.

Felix.
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Fx Femur