The risk of limb loss following a vascular injury in the extremity may be increased when certain clinical findings are present.


Factors associated with increased risk of limb loss following vascular trauma:

(1) delay in treatment (> 6 hours)

(2) blunt mechanism of injury

(3) injury to lower extremity, especially the popliteal artery

(4) injury involving other structures such as nerve, vein, bone, and/or soft tissue

(5) high velocity gunshot wounds

(6) close range shotgun wounds

(7) pre-existing atherosclerotic disease

(8) delay or failure to perform fasciotomy after development of a compartmental syndrome



• The risk of limb loss would seem greater for an arterial lesion than venous injury.

• Many of these factors are associated with the mangled limb syndrome (see below).


Some additional factors not listed in the reference:

(9) poor application of a tourniquet

(10) hypercoagulable state

(11) severe, uncontrolled infection (gas gangrene, etc.)


To read more or access our algorithms and calculators, please log in or register.