Crush Injury of Left Cruris Region with Vascular Injury: A Case Report

Abstract: Crush injuries resulting from traffic accidents, cause severe damage to soft tissues, muscles, and nerves, leading to complications such as compartment syndrome and vascular injury. Vascular injuries may require timely diagnosis and intervention to prevent limb loss or death. Through-knee amputation (TKA) with anterior flap is an effective technique for preserving limb function while minimizing amputation extent. The procedure is less complex, reduces infection risks, and promotes better healing compared to more extensive amputation methods. We reported a 46-year-old male who suffered from a severe traffic accident resulting in intense pain and significant bleeding in the left lower leg (cruris sinistra). Upon physical examination and vital signs, no abnormal findings were noted. The local examination revealed an open fracture with surrounding tissue avulsion in the left lower leg, with a MESS of 8. X-ray and Doppler ultrasound confirmed tibia and fibula fractures with associated vascular damage. The patient underwent a through-knee amputation (TKA) with an anterior flap, aimed at preserving limb function while addressing severe vascular and soft tissue damage. Comprehensive follow-up care, including adequate antibiotics, post-surgical transfusion, analgesics, rehabilitation, and psychological support, was provided to promote recovery. In conclusion, through-knee amputation is a viable option for patients aiming to preserve as much limb function as possible, providing significant long-term benefits, followed by post-operation ambulatory and rehabilitation. This case highlights the successful outcome of TKA, with complete wound closure after one week of care, and emphasizes the importance of comprehensive post-operative rehabilitation, including physical therapy, occupational therapy, and psychiatric support, to enhance the patient's quality of life and functional recovery. Keywords: crush injury; vascular injury; through-knee amputation