AB166. SOH25_AB_018. Delayed diagnosis of common femoral artery occlusion caused by blunt sports trauma

Background: Traumatic vascular injuries of the lower limbs require prompt identification to prevent ischemia and limb loss. In cases without obvious signs of vascular compromise, non-limb-threatening injuries can be missed, leading to serious consequences. High-energy trauma patients, often with multiple injuries, must be assessed according to advanced trauma life support (ATLS) guidelines, including a secondary survey and appropriate imaging.

Methods: This case report details a rare instance of blunt sports-related thigh injury without fracture or dislocation, complicated by delayed diagnosis of a common femoral artery occlusion discovered 7 years post-injury. The retrospective analysis included clinical presentation, imaging, operative findings, and follow-up assessments.

Results: Many vascular injuries stem from blunt trauma, and delayed diagnosis is more frequent in such cases. The initial assessment adhered to ATLS guidelines, emphasizing history, physical examination, and vigilant evaluation for subtle vascular signs. The arterial pressure index is a valuable tool for identifying vascular compromise. Advanced imaging, such as computed tomography angiography, is critical for identifying and managing vascular injuries, especially in young patients whose rapid collateral circulation development may mask early symptoms. A delay in detecting vascular damage can lead to progressive stenosis, such as arterial endofibrosis, and severe complications like limb shortening and growth disturbances in children.

Conclusions: In sports-related trauma, a thorough history and ATLS-guided examination are essential, even in cases without fractures, as blunt trauma can cause significant vascular injury. Unrecognized vascular injuries may present later as exercise-induced claudication, underscoring the need for vigilance in young patients following trauma.

Keywords: Vascular injury; blunt trauma; sports trauma; femoral artery; motor scooter handlebar syndrome