Most bullets made of lead alloy

Vascular lesion with associated fracture:

• Vascular lesion with associated fracture:

• Vascular repair necessitates stabilized fracture

• What should be done first?

• Dependant on limb ischemia time
• Temporary shunt may allow rapid revascularization and adequate redundancy to regain limb length
• Dependant upon time needed for stabilization
• External fixation may temporarily provide stability in a timely fashion
• Communication among services important

71% with arterial injury have nerve injury

• 71% with arterial injury have nerve injury

• 39% of patients without nerve injury and vascular repair will have normal extremity
• 7% of patients with nerve injury and arterial repair will have normal extremity

Most show signs of recovery 2-4 weeks

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