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Eur J Trauma Emerg Surg. 2018 Apr 4. doi: 10.1007/s00068-018-0951-6. [Epub ahead of print]

Penetrating femoral artery injuries: an urban trauma centre experience.

Rayamajhi S1,2,3, Murugan N1,2,3, Nicol A1,2,3, Edu S1,3, Klopper J2,3, Naidoo N2,4,3, Navsaria P5,6,7.

Author information

1
Trauma Center-C14, Observatory, Groote Schuur Hospital, Cape Town, 7925, South Africa.
2
Department of Surgery, Groote Schuur Hospital, Cape Town, 7925, South Africa.
3
Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
4
Division of Vascular Surgery, Groote Schuur Hospital, Cape Town, 7925, South Africa.
5
Trauma Center-C14, Observatory, Groote Schuur Hospital, Cape Town, 7925, South Africa. pradeep.navsaria@uct.ac.za.
6
Department of Surgery, Groote Schuur Hospital, Cape Town, 7925, South Africa. pradeep.navsaria@uct.ac.za.
7
Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. pradeep.navsaria@uct.ac.za.

Abstract

AIM:

This study reviews a single centre experience with penetrating femoral artery injuries.

PATIENTS AND METHODS:

The records of all patients with femoral artery injuries admitted to the Trauma Centre at Groote Schuur Hospital from January 2002 to December 2012 were reviewed. These were analysed for demographics, injury mechanism, perioperative, and surgical management. Outcome was categorised by limb salvage.

RESULTS:

One-hundred and fifty-eight (158) patients with femoral artery injuries were identified. There were 144 (91%) men and 14 women with a mean age of 28 years. Ninety-five percent (N = 150) sustained penetrating injuries. The superficial femoral artery (87%) was most commonly injured. The most common type of arterial injury was a laceration (39%) and transection (37%). Eighty-one (51%) patients had a primary repair, 53 (33%) patients had a vein interposition graft, and 16 patients (10%) had a prosthetic graft. There were 78 (51%) concomitant venous injuries, 11 were repaired, and 1 vein patch repair was performed (15.4%). There were 4 (2.5%) primary amputations and 10 (6.5%) secondary amputations. There were no deaths. Statistically significant risk factors for secondary amputation derived by univariate analysis were: ischaemia (p < 0.0001), neurological deficit due to ischemia (p < 0.001), temporary vascular shunting (p < 0.001), and the absence of a palpable pulse post-repair (p < 0.01).

CONCLUSION:

This study has a primary and secondary amputation rate of 2.5 and 6.5%, respectively. There was greater than 90% limb salvage rate. The outcome of threatened limbs due to femoral artery injury is good, provided that there is no delay to surgery.

KEYWORDS:

Amputation; Femoral artery; Penetrating trauma

PMID:
29619536
DOI:
10.1007/s00068-018-0951-6

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