@article{ref1,
title="Predictors of peripheral vascular injury in patients with blunt lower extremity fractures",
journal="Annals of vascular surgery",
year="2019",
author="Marcia, Lobsang and Kim, Dennis Y.",
volume="57",
number="",
pages="35-40",
abstract="BACKGROUND: Early identification of peripheral vascular injuries is crucial to prevent acute limb ischemia and amputation. We sought to identify predictors of vascular injury in patients with blunt lower extremity fractures. <br><br>METHODS: A single institutional retrospective analysis of patients with blunt lower extremity fractures at a university-affiliated, County hospital over a 2-year period was performed. Patients with lower extremity vascular injury were compared to patients without. Multivariate logistic regression analysis was performed to identify independent predictors of vascular injury. <br><br>RESULTS: Two hundred and seventy-four patients were identified. The mean age was 37.2 ± 17.6 years and 73.7% were male. The most common mechanisms were auto vs. pedestrian/bicycle (44.2%) and motor vehicle accidents (27.7%). Twenty-two patients (8.0%) had vascular injuries, of which the most commonly injured arteries were: the anterior tibial artery (8, 36.4%) and the posterior tibial artery (8, 36.4%). Patients with vascular injuries were more likely to have a tibia-fibula fracture (90.9% vs 52.4%, p < 0.01), an open fracture (63.6% vs 21.8%, p < 0.01), and a mid-shaft fracture (59.1% vs 19.4%, p<0.01). Amputation was required in 3 patients (13.6%) with a vascular injury. On multivariate analysis, a tibia-fibula fracture (OR=5.48, 95% CI= 1.15-26.1, p<0.05), an open fracture (OR=3.87, 95% CI= 1.37-11.0, p=0.01) and mid-shaft fracture (OR=2.91, 95% CI=1.04-8.1, p <0.05) were associated with the presence of a vascular injury. <br><br>CONCLUSION: Open tibia-fibula fractures particularly those involving a mid-shaft location are independent predictors of vascular injuries in patients with blunt lower extremity fracture. These findings may help identify patients requiring diagnostic and surgical intervention.<br><br>Copyright © 2019. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0890-5096",
doi="10.1016/j.avsg.2018.12.056",
url="http://dx.doi.org/10.1016/j.avsg.2018.12.056"
}