The Femoral and popliteal artery are the most affected arteries.

 

Management

  • 1st Line: Direct compression and elevation
  • 2nd Line: Tourniquet (document time)

Direct Signs

Take directly to theatre. If it does not cause significant delay and physiology permits, consider CT angiography on route to theatre.

Indirect Signs

Perform CTA.

Non-operative management (NOM)

Asymptomatic non-occlusive arterial injuries may undergo NOM with subsequent repair if indicated.

Surgery

  • Temporary vascular shunts may be used in damage control scenarios.
  • Tibial vessels may be ligated if there is documented flow distally.

IR

Embolisation of profunda branches or tibial vessels is acceptable.

Compartment syndrome

Apply fasciotomy liberally when there is an associated injury or there has been prolonged ischaemia. If not performed, place a compartment monitor.