J Bone Joint Surg [Br] 1989:71-B:704. 704 BRIEF REPORTS THE JOURNAL OF BONE AND JOINT SURGERY UNEXPECTED SECOND ARTERIAL INJURY IN THE LOWER LIMB

Multiple arterial injuries associated with blunt trauma of the extremities are difficult to manage. Successful treatment depends upon early diagnosis and prompt revascularisation. We report a case where a second arterial injury in the same limb remained undetected, leading to delay in revascularisation. Case report. A 20-year-old motorcyclist was admitted with multiple injuries following a road traffic accident. Clinical and radiological examination revealed a closed comminuted fracture ofthe mid-shaft ofthe femur, distal to which the circulation was absent. A minimally displaced, transverse fracture of the right medial mal!eo-lus was also noted. Immediate manipulation failed to restore limb perfusion and exploration demonstrated a 1 cm patc