Team Approach: Combined Orthopaedic and Vascular Injury
A complex extremity injury associated with a vascular injury requiring repair can be one of the most challenging musculoskeletal injuries that an orthopaedist might treat. The challenge goes well beyond the definitive treatment of what typically are difficult fractures to reconstruct and even beyond the tough decision between limb salvage and amputation. These injuries always represent an emergency situation in which urgent decisions must be made with use of a multidisciplinary team approach. Practice guidelines should be discussed and established at the trauma center prior to presentation of the trauma patient to help expedite decision making. The difficulty is in deciding when it is appropriate to deviate from the guidelines as the individual scenario might require.