Utility of CT Angiography in Patients with Lower Extremity Fractures

Lower extremity fractures may result in arterial injury, and delayed recognition can worsen outcomes. Computed tomography angiography (CTA) is routinely used to detect vascular injury, especially in patients with femur fractures, but whether clinical examination alone is sufficient to detect vascular injury is unclear.

Investigators reviewed medical records for 247 patients who underwent 275 lower extremity CTA studies at a Level 1 academic trauma center. Mechanism of injury, fracture pattern, and presence of hard signs of vascular injury (e.g., pulsatile bleeding, pale limb, absent pulse, expanding hematoma) and soft signs (e.g., nonpulsatile bleeding, decreased pulse, peripheral nerve deficit) were recorded. Logistic regression was used to…