OUTCOMES OF FEMORAL ARTERY REPAIR WITH INTERPOSITION VEIN GRAFT: BLUNT VS PENETRATING TRAUMA

Abstract

Background: Fractures of the femur are life-threatening injuries of the limbs and must be treated immediately. Mechanism of injury (blunt or penetrating) affects vascular injury, complications, and clinical outcomes.

Objective: To compare six-month graft patency and limb salvage following femoral artery repair with interposition vein grafting in patients with blunt versus penetrating trauma.

Methods: This is a retrospective cohort study that was carried out in Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi from January 2020 to December 2025. One hundred and twenty seven patients were included (72 blunt trauma and 55 penetrating trauma). Medical records were used as a source for data collection which was done with the help of a structured proforma. Primary outcomes were the patency of the graft and salvage of the limb at six months; secondary outcomes were postoperative complications, hospital stay, recovery time and rehabilitation needs. SPSS (version 26.0) was used for statistical analysis.

Results: Patients with blunt trauma demonstrated lower graft patency compared with penetrating trauma (72.2% vs 85.5%, p=0.048) and reduced limb salvage rates (76.4% vs 89.1%, p=0.041). Early complications were more common with blunt trauma although this was not statistically significant. Blunt trauma was significantly associated with prolonged hospitalization (13.4±4.8 vs 9.6±3.9 days, p<0.001), longer recovery duration (9.5±3.4 vs 6.8±2.6 days, p<0.001), and increased rehabilitation requirements (63.9% vs 43.6%, p=0.020).

Conclusions: Blunt femoral artery trauma has a delayed presentation, compromises graft patency, hinders limb salvage, and prolongs recovery, thus emphasising the importance of early detection and prompt revascularization.