الفهرس 
Introduction and aim of workOnly 14 pages are availabe for public view
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Abstract
Objective: ?To evaluate our experience in lower extremity vascular injury and to review the risk factors associated with lower limb loss. Patients and Methods: This study included 88 patients with lower extremity vascular injuries admitted to vascular surgery unit in emergency hospital of Mansoura University from January 1997 to January 2003. Patients were assessed on presentation and resuscitation protocols were initiated if signs of shock were present. Arterial injuries were repaired by: primary repair, resection and anastomosis , interposition graft, artery ligation , temporary shunts and extraanatomical bypass. Venous injuries were repaired by the same techniques but when the repair would be complex or the patients is hemodynemically unstable simple ligation was done. Primary amputation was done for patients where limb salvage was impossible clinically. MESS score was applied on our cases to obtain a score which predict the eventual need for amputation.Results: It was found that the most frequent cases of injury was that resulting from blunt trauma (52.2%) and it was the highest variable associated with limb loss (52.1% amputation rate). The crural arterial injuries carried the highest rate of limb loss(50% amputation rate). It was also found that compound fractures (75%), crushed muscles (78.1%) and nerve injury (72.7%) had high incidence of limb loss. MESS of > 8 show 100% amputation and < 7 show 94.5% limb salvage while score = 7 or 8 show 66.7% amputation rate.Conclusion: Compound fractures, arterial transsection , thrombosis and crural injuries are associated with higher risk of limb loss. Venous repair is done only in stable patients by simple repair, end to end anastomosis or venous patch. Ligation is done in unstable patients with no adverse influence of venous ligation on limb salvage. The MESS has significant correlation with amputation outcome with score > 8 but with score = 7 or 8 must be evaluated mainly on clinical basis