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Marlin Wayne Causey, MD, Morohunranti O

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1 Limb salvage after delayed diagnosis for blunt traumatic infrapopliteal occlusion 
Marlin Wayne Causey, MD, Morohunranti O. Oguntoye, MD, Seth Miller, MD, Charles Andersen, MD, Niten Singh, MD  Journal of Vascular Surgery  Volume 52, Issue 3, Pages (September 2010) DOI: /j.jvs Copyright © Terms and Conditions

2 Fig 1 Left two pictures demonstrate fracture on the day of presentation and right two pictures after orthopedic repair. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

3 Fig 2 A and B, demonstrate the initial presentation of the ischemic foot ulcers. Medial (C) and lateral views (D) show the extent of injury after the bypass and ischemic eschars before debridement. After appropriate debridement and preparation of the wound bed (F), split-thickness skin grafts were performed (E and G), with a good healing result 6 months later (H and I). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

4 Fig 3 A, The anterior tibial artery has slow flow beyond the mid portion and occludes distally at the level of the tibial plate (thick arrow). The posterior tibial artery is widely patent to the level of the medial malleolus where it abruptly occludes and is reconstituted rapidly by collaterals (thin arrow). The peroneal artery is occluded at its distal aspect (asterisk). B, Three-dimensional reconstruction after the bypass (left is anterior and right is posterolateral). Solid arrows represent the posterior tibial-to-posterior tibial bypass graft and dashed arrows represent anterior tibial-to-dorsalis pedis bypass graft. C, The anterior tibial artery was occluded at its prior occluded position (*). The posterior tibial graft was patent but with a high-grade stenosis of the proximal anastomosis. After angioplasty (arrow) with a 3-mm × 2-cm balloon, there was excellent angiographic resultant flow. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

5 Fig 4 Evaluation, workup, treatment, and surveillance of delayed diagnosis of blunt infrapopliteal vascular injury. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

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