High-energy trauma and damage control in the lower limb.

Management of traumatic lower-limb vascular injury can offer special challenges even to experienced surgeons. Recent U.S. conflicts have advanced the practice of vascular trauma surgery on the battlefield and offer important lessons learned for management of similar injury in urban trauma centers. Damage control techniques for complex injuries when associated with hemodynamic instability may provide an opportunity to save both life and limb. This article provides an overview of damage control principles in the management of high-energy traumatic vascular injuries of the lower limb during recent U.S. military combat operations.