A 65-year-old man is brought to the hospital after being hit by a car. His blood pressure is 150/90 mm Hg, and pulse is 120 bpm. There is deformity just below the left knee and no distal pulses palpable in that leg. Plain films show proximal tibia and fibula fractures. What is the next step in management?
In a stable patient presenting with peripheral vessel occlusion following blunt trauma, angiography is indicated to plan the appropriate operative approach. An angiogram can also document preexisting arteriosclerosis, collateral circulation, and distal runoff. Doppler ultrasound is useful to localize the injury site but gives less information regarding collateral circulation. Immediate operation to control bleeding and restore flow is indicated if the patient's condition is unstable.
Operative intervention to restore flow with an arterial shunt
Angiography
Doppler ultrasound
Operative reduction and internal fixation
Trauma