LIMB SALVAGE AFTER BONY AND VASCULAR GUNSHOT INJURIES IN A 5-WEEK-OLDINFANT

Combined bony and vascular injuries present challenging problems to or thopaedic and vascular surgeons, The use of temporary intraluminal vas cular shunts produces significant reductions in ischaemia time and all ows fracture stabilisation to be performed before definitive, delicate vascular repair. We report our management of a five-week-old infant w ho sustained a comminuted fracture of the femur with arterial and veno us injuries in a shooting incident, Paediatric nasogastric feeding tub es were used as temporary vascular shunts to re-establish the distal c irculation, Stabilisation of the fracture was then followed by vascula r reconstruction and soft-tissue surgery, with a good result. We empha sise the need for skills from several surgical disciplines in the mana gement of complex combined injuries.