Results of reconstruction in major pelvic and extremity venous injuries

Anteroposterior radiogram of the left thigh after close range injury by 2 large fragments of an explosive-filled lead pipe. Entry wound was in the lateral lower thigh, with massive bone and soft tissue destruction and avulsion of the superficial femoral vessels. The sciatic nerve was spared. The artery and the vein were repaired with interposition grafts of reversed saphenous vein and panel graft, respectively, and the bone was stabilized with intramedullary fixation. The wound was reexplored after 7 days, and the patient underwent full recovery, with a 4-cm shortening of the left femur.

Follow-up examination of a fully recovered young man, 8 months after high-velocity gunshot injury of the right thigh with spiral graft repair of the superficial femoral vein. A, A patent superficial femoral vein of the right leg demonstrated by means of venogram. The intramedullary nail and the femoral callus are evident. B, Patency and phasic flow with respiratory variation demonstrated by means of duplex of the same vein.