A transtibial amputation following femoral artery injury: application of military trauma protocols in civilian care – a case report

Ahmed Ali Shabhay; Sjef G. Van Baal; Pim van den Hoven; Zarina Ali Shabhay; Nancy Wambura; Jay Lodhia; Fabian Massaga

doi:10.18203/2349-2902.isj20263861

Authors

Ahmed Ali Shabhay Department of General Surgery, Kilimanjaro Christian Medical University College (KCMUCo), P.O. Box 2240 Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre (KCMC), P.O. Box 3010 Moshi, Tanzania; Institute of Infectious Diseases and Research, Lugalo Military College of Medical Sciences (MCMS) and General Military Hospital (GMH), P.O. Box 60000 Dar es Salaam, Tanzania https://orcid.org/0000-0001-9214-5415
Sjef G. Van Baal Medical Advisor STEPP Organization Hengelo, The Netherlands
Pim van den Hoven Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Department of Surgery, The Netherlands
Zarina Ali Shabhay Muhimbili Orthopedic Institute (MOI), P.O. Box 65474, Dar es Salaam, Tanzania https://orcid.org/0000-0002-1484-3338
Nancy Wambura Department of Surgery, Bugando Medical Center, P.O Box 1370 Mwanza, Tanzania https://orcid.org/0009-0009-2313-7804
Jay Lodhia Department of General Surgery, Kilimanjaro Christian Medical University College (KCMUCo), P.O. Box 2240 Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre (KCMC), P.O. Box 3010 Moshi, Tanzania https://orcid.org/0000-0002-3373-5762
Fabian Massaga Department of Surgery, Bugando Medical Center, P.O Box 1370 Mwanza, Tanzania

DOI:

https://doi.org/10.18203/2349-2902.isj20263861

Keywords:

Superficial femoral artery, Penetrating vascular injuries, Thrombectomy, CT angiography

Abstract

Surgical management of vascular injuries remains a daunting challenge to practicing clinicians. Timely and appropriate management is critical. We present a case of a 20 -year-old man who sustained a penetrating vascular injury that led to a transtibial amputation of his left lower limb due to distal vascular occlusion. Inappropriate and untimely management of vascular injuries can lead to limb and life loss. Military protocols adopted during battlefield care have contributed to the development of new guidelines in civilian settings. Due to increasing violence, crime rates, and contemporary threats such as improvised explosive devices associated with terrorist attacks in urban settings, civilian medical personnel have started to encounter high-energy blast injuries in urban medical centers that mimic war injuries. Timely and appropriate management is critical in preventing limb and life loss. It is the author’s opinion that vascular injuries should be managed by trained vascular specialists.

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