[Traumatic peripheral XXXX ].

@entity1 @entity1545 @entity4438 @entity174 @entity63 @entity190 @entity254 @entity1317 @entity2548 @entity2849
2-4% of @entity1317 need operative reconstruction. In polytraumatized @entity1 the rate is even 10%. Arterial vascular repair should precede venous reconstruction and orthopaedic stabilization due to limb threatening @entity63 . Penetration or blunt @entity1545 result either in acute @entity190 , @entity63 or compartmental compression. Reperfusion syndrome leads to vital threat of @entity1 . Clinical assessment, measurement of limb pressures using a Doppler device and use of duplex ultrasonography are reliable adjuncts in the rapid evaluation. Arteriography is rarely indicated and should be spared for @entity1 with abnormal physical examination. Minimizing @entity63 (6-8 h) is an important factor in maximizing limb salvage. Vascular repair include direct @entity254 or lateral suture repair mostly combined with primary shortening of the extremity. In most cases autogenous vein graft is required. Rethrombosis, @entity2548 and @entity2849 are possible complications. Stabilisation of the @entity174 has priority over vascular reconstruction. The initial steps to success are surgical debridement, adequate bony stabilization mostly by external fixation, revascularisation of @entity1317 , @entity4438 and early soft-tissue reconstruction. The best results are obtained when a multidisciplinary approach is used combining expertise in orthopedic surgery, vascular surgery and plastic surgery.
