Posterior Tibial Artery Injury with Intact Posterior Tibial Pulse: A Case Report

Abstract

The presence of distal pulses can be misleading and the presence of good vascularity to the affected part may be unrelated to the possibility of a vascular injury in orthopaedic trauma to the affected part. We report a case of Grade II open fracture of Proximal Tibia with Posterior Tibial Artery (PTA) tear. The case being presented came with an intact PTA pulsations clinically and with good vascularity to the lower limb, with no difference in the pulse rate between radial and posterior tibial pulse rate and no underlying bruits. The underlying PTA tear was found only incidentally on operating when the patient was taken up for open reduction with internal fixation with proximal tibial locking plate surgical procedure and the fracture site was opened. Arterial injuries following trauma may be missed without liberal use of arterial Arteriograms and Doppler study, unless looked for with a high degree of suspicion. If the arterial tear is identified early, patient and his limb can be saved without much morbidity to the patient, though diagnosing the injury is the hard part. Presence of intact and good peripheral pulses is not a sole criteria to rule out underlying vascular injury following orthopaedic trauma.

Keywords

• intact arterial pulse post injury
• limb ischaemia
• vascular injury