J Reconstr Microsurg 1995; 11(2): 107-111
DOI: 10.1055/s-2007-1006517
ORIGINAL ARTICLE

© 1995 by Thieme Medical Publishers, Inc.

Revascularization of a Seven-Week-Old Infant Lower Extremity: Case Report

P. A. Clugston, D. J. Courtemanche, I. Lawson, L. B. Christensen, S. Tredwell
  • From the Section of Surgery, Division of Plastic Surgery and Department of Orthopedic Surgery, British Columbia Children's Hospital, Vancouver, Canada
Further Information

Publication History

Accepted for publication 1994

Publication Date:
08 March 2008 (online)

ABSTRACT

A seven-week-old infant suffered a closed segmental fracture of the left tibia and fibula complicated by vascular disruption and a secondary compartment syndrome. Initial orthopedic assessment revealed a clinically mottled, cool, pulseless extremity 4 hr post-injury. Radiologic investigations showed multiple displaced fractures of both the tibia and fibula. The infant underwent four compartment fasciotomies and intramedullary nailing of the tibial fractures. The vascularity of the limb failed to improve significantly. Angiograms done 22 hr post-injury revealed disruption of arterial inflow just distal to the bifurcation of the tibial peroneal trunk and posterior tibial artery. Urgent revascularization utilizing a contralateral greater saphenous vein graft was undertaken with a successful outcome.

Despite delay in transport from the community hospital and lack of definitive management of the vascular injury, the infant has had a good-to-excellent functional outcome.