Haemorrhage from arterial or venous injury may result in hypovolaemic shock
Penetrating injuries can result in transection of a vessel
Fractures/dislocations of different bones and joints can affect associated vasculature
Knee dislocation → popliteal artery injury
Paediatric supracondylar fracture of the elbow → brachial artery injury
Shoulder trauma → axillary artery injury
Management
Any signs of reduced distal circulation (reduced or absent pulses, pallor, delayed capillary refill, cold to touch) mandates urgent vascular surgery review and emergency surgical management
Urgent angiography in theatre may help localize the site of arterial occlusion
Temporary restoration of circulation can be achieved with use of a vascular shunt or vascular repair with either a bypass graft or endoluminal stent can be perfomed
Skeletal stabilization with internal or external fixation should be performed to protect the repair from shearing force
Ongoing haemorrhage from arterial injury in the pelvis can be controlled by angiographic embolization performed by interventional radiologists
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