Tibial vessel injuries (3) - Repair of the posterior tibial artery!
Fig: Spiral CT and Intra -Operative photo
Tibial vessel injuries are generally managed conservatively as one of the three is usually is patent and supplies adequate blood to the distal leg and foot. Rarely we see all the three vessels are injured and distal foot is ischemic. In such situations we do consider repair of one of the tibial vessels to save the ischemic foot. In this case ( fig) posterior tibial artery was repaired ( resection and anastomosis) and the other occluded vessels are not repaired. Nerve injury is left for the secondary repair. At the end of the procedure the repaired posterior tibial artery is pulsting well beyond the anastomosis.