A transtibial amputation following femoral artery injury: application of military trauma protocols in civilian care – a case report

Surgical management of vascular injuries remains a daunting challenge to practicing clinicians. Timely and appropriate management is critical. We present a case of a 20 -year-old man who sustained a penetrating vascular injury that led to a transtibial amputation of his left lower limb due to distal vascular occlusion. Inappropriate and untimely management of vascular injuries can lead to limb and life loss. Military protocols adopted during battlefield care have contributed to the development of new guidelines in civilian settings. Due to increasing violence, crime rates, and contemporary threats such as improvised explosive devices associated with terrorist attacks in urban settings, civilian medical personnel have started to encounter high-energy blast injuries in urban medical centers that mimic war injuries. Timely and appropriate management is critical in preventing limb and life loss. It is the author’s opinion that vascular injuries should be managed by trained vascular specialists.