2. ΑΙΤΙΑ ΚΑΚΩΣΕΩΝΑΙΤΙΑ ΚΑΚΩΣΕΩΝ
ΤΡΟΧΑΙΑΤΡΟΧΑΙΑ
ΠΤΩΣΕΙΣΠΤΩΣΕΙΣ
ΚΑΚΩΣΕΙΣ ΑΠΟ ΠΥΡΟΒΟΛΑ ΟΠΛΑΚΑΚΩΣΕΙΣ ΑΠΟ ΠΥΡΟΒΟΛΑ ΟΠΛΑ
ΤΡΑΥΜΑ ΑΠΟ ΝΥΣΣΟΝ ΟΡΓΑΝΟΤΡΑΥΜΑ ΑΠΟ ΝΥΣΣΟΝ ΟΡΓΑΝΟ
ΕΓΚΑΥΜΑΤΑΕΓΚΑΥΜΑΤΑ
ΤΟ 80% ΟΛΩΝ ΤΩΝ ΑΓΓΕΙΑΚΩΝΤΟ 80% ΟΛΩΝ ΤΩΝ ΑΓΓΕΙΑΚΩΝ
ΚΑΚΩΣΕΩΝ ΑΦΟΡΟΥΝ ΤΑ ΑΚΡΑΚΑΚΩΣΕΩΝ ΑΦΟΡΟΥΝ ΤΑ ΑΚΡΑ
12. DiagnosisDiagnosis ofof VascularVascular
injuryinjury
Hard Signs ofHard Signs of
Distal ischemiaDistal ischemia
The 5 Ps:The 5 Ps:
painpain
pallorpallor
paralysisparalysis
paresthesiasparesthesias
poikilothermypoikilothermy
or coolnessor coolness
Knee Dislocation
13. ManagementManagement of Complexof Complex
Extremity TraumaExtremity Trauma
Initial Fracture Stabilization andInitial Fracture Stabilization and
FixationFixation
has been advocated in past years, duehas been advocated in past years, due
to concerns that an establishedto concerns that an established vascularvascular
repairrepair will be disrupted by subsequentwill be disrupted by subsequent
orthopaedic manipulationorthopaedic manipulation
14. ManagementManagement of Complexof Complex
Extremity TraumaExtremity Trauma
If Revascularization is performed firstIf Revascularization is performed first
Clinical studies have shown a substantiallyClinical studies have shown a substantially
higher rate of limb salvagehigher rate of limb salvage
compared with those in which it is delayedcompared with those in which it is delayed
until the skeleton is addresseduntil the skeleton is addressed
BUTBUT this is true only forthis is true only for
Undisplaced, stable blunt fracturesUndisplaced, stable blunt fractures
15. ManagementManagement of Complexof Complex
Extremity TraumaExtremity Trauma
Definitive vascular repair should beDefinitive vascular repair should be
delayeddelayed in cases ofin cases of
unstable or severely comminuted fracturesunstable or severely comminuted fractures
dislocationsdislocations
segmental bone losssegmental bone loss
severe soft tissue destruction andsevere soft tissue destruction and
contaminationcontamination
16. ManagementManagement of Complexof Complex
Extremity TraumaExtremity Trauma
Immediate restoration of perfusionImmediate restoration of perfusion
Temporary intraluminal shunting untilTemporary intraluminal shunting until
skeletal stabilization and soft tissueskeletal stabilization and soft tissue
debridement has been completeddebridement has been completed
17. RTA, Open IIIc HumerusRTA, Open IIIc Humerus
FractureFracture
Vascular Surgeons – Orthopaedic Surgeons – Plastic Surgeons