[Acute ischemia of the limbs caused by concomitant vascular injury in proximal shaft fractures with soft tissue damage].

Combined skeleto-vascular lesions of the proximal parts of the extremities endanger not only the limb but also life. Operative treatment has to be carried out as soon as possible. Stabilisation of the fracture has priority over vascular reconstruction. This paper reports 39 skeleto-vascular lesions. The most important singular factor to improve the prognosis is the reduction of the time interval between the accident and the restoration of regional blood flow. This can be achieved by avoiding time consuming diagnostic measures, quick stabilisation of the fracture by external fixation, temporary circulation by an intraluminal shunt, and by simultaneous operation. It is important to avoid a post-ischaemic compartment syndrome by early fasciotomy.