Abstract
A 66-year-old male had his right leg crushed by a falling concrete wall. Radiogram and angiogram revealed open fracuture of the femoral condyle and popliteal artery laceration. Immediately, anastomosis of the lacerated artery was attempted. Eight hours after injury, we had succeeded in reperfusing the lower leg. Fracture of the femoral condyle was stabilized with Hoffman's external fixator. To prevent the complications of fat embolism, crush syndrome or replantation toxemia, intensive care including artificial ventilation (with positive end expiratory pressure) and continuous arterio-venous hemofiltration was started. However, the patient developed symptoms of multiple organ failure (accompanied by DIC, pulmonary embolism, renal failure, liver failure) two days after injury. Three days after injury, rupture of the small intestine became apparent and was treated immediately. Despite this, the patient died on the 8th day after injury.
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