Arterial trauma of the limbs represents about 0.5% of all civilian trauma. Blunt trauma is the most frequent mechanism in civilian records, although penetrating trauma, especially gunshot wounds, is increasing. While over 95% of isolated injuries from penetrating trauma is successfully treated, blunt trauma lesions, particularly associated with musculoskeletal injuries, lead to a very high amputation rate, in some records over 50%. Despite progress in pathophysiology and surgical techniques, there are still different controversies in diagnosis and treatment of these patients. Unfortunately, due to the emergency treatment and lack of centers with sufficient numbers of cases, it is not generally possible to make control studies with level 1 or 2 evidence.
Therefore the majority of clinical studies are retrospective and case reports, cohort studies, or series of single centers, often limited in numbers.
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