Our experience in 31 cases of vascular lesions in open fractures

A carefully preoperatory evaluation of limb ischemic damage is mandatory. Angiography is essential in dobiuos cases. The surgical techniques of repair employed were: anastomosis with or without patch, venous autotransplat, for small arterial tissues losses when the venous autotransplant is not advisable for the surrounding tissues conditions, it is eventually possible to resect a small portion of the bone with a resulting little shortening of the limb. Stable skeletal fixation is essential to assure a strong support to the vessels repair and it must preceed the vascular surgical reapir. If the preopeartory ischemic period has been long or if, owing to the fact of the fracture particular nature a long bone repair is foreseen, it is possible to accomplish a perfusion of the ischemic limb with cooled Ringer solution, or to perform the vascular repair before the bone fixation.