Successful Limb Salvage Using a Fresh Maternal Great Saphenous Vein Allograft for Combined Femoral Artery and Vein Transection After Gunshot Injury in a Child

Major vascular trauma in children is rare and presents significant reconstructive challenges when autologous conduit options are limited. We report a 2-year-old boy with a close-range shotgun injury causing complete transection and segmental loss of the superficial femoral artery and vein with associated open femoral fracture and acute limb ischemia. Because the child's great saphenous veins were unsuitable for reconstruction, a fresh maternal great saphenous vein allograft was used for arterial repair, while the femoral vein was ligated. Limb perfusion was successfully restored without immunosuppression. At 4-year follow-up, the limb remained viable and functional despite graft occlusion due to robust collateral arterial development.