Case Presentation
A case of a young male, restrained passenger who was involved in a rollover motor vehicle crash. A metal road sign pole was impaled through and through his right lower extremity.
Impalement through right thigh
He was taken to OR with a shattered femur and transected superficial femoral artery and vein. After removing the sign post, we ligated his superficial femoval vein and placed a temporary shunt in the artery between the superficial femoral and popliteal arteries. Orthopaedics then plated his femur. and we then performed a bypass of his superficial femoral artery with contralateral greater saphenous vein.
Shunt in superficial femoral artery
He was able to ambulate with a functional limb post operatively and did surprisingly well!
Discussion & References
For discussion and references on the management see the articles on Combined Skeletal & Vascular Injury and Damage Control Surgery
Submitted by: Richard Koehler, Steve Merrell
Comments
On 07/10/2007, Dr.Suhail yaqoob commented:
Good job done.Kindly specify the nature of ur temporary shunt and what handy alternatives do u suggest with the precautions if any.
On 09/14/2007, sarfile commented:
How long it takes to graft the femoral artery ?
what about maceration of tissues ? how long it takes to heal? is he able to bend or use his knee? thanks for enlightening
On 12/26/2007, christine horman commented:
my question is,did this patient have to under go extensive physical therapy? it would seem as if after such a traumatic injury of that magnatude,there would be at least some permenant damage to limit use of his limb..christine horman