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Featured Article: Standards for the management of open fractures of the lower limb
New comprehensive, evidence based guidelines on the management of open fractures should lead to reorganisation of service delivery and a more comprehensive approach to these potentially catastrophic injuries.
Featured Case Study: Venous laceration to lower limb without fasciotomy
Trauma surgeons deal rarely with isolated penetrating venous injuries to the lower limbs due to the proximity of the vein-arterial complex. The limb remains vascularized but intensely swollen and a fasciotomy must be considered. Inserting a 'drip line' into both severed ends permits immediate venous return and improves the venous hypertension to the point where a fasciotomy can be avoided. This 'damage control' act does allow one to come back a day later and to reestablish continuity with any interposition graft available. The contralateral long saphenous is first choice, a synthetic graft second, a ligature and fasciotomy third choice.
