Blunt Trauma to the Common Femoral Artery From Motorcycle Handlebar Impact: A Case of Extensive Thrombosis

TL;DR

A motorcycle accident caused a rare 71 cm blood clot in the femoral artery, highlighting the need for early detection of vascular injuries in blunt trauma.

Contribution

Reports a rare case of extensive thrombosis in blunt trauma without fractures, emphasizing early diagnosis and surgical intervention.

Findings

A 71 cm thrombus was identified in the common femoral artery after a motorcycle accident.

Successful surgical removal of the clot restored limb function with no complications.

The case highlights the importance of suspecting vascular injury in blunt trauma without skeletal fractures.

Abstract

Blunt trauma can cause significant vascular injury even in the absence of fractures or penetrating wounds, and such injuries are often underdiagnosed. In this case, the rarity lies in the intraoperative identification of an unusually extensive thrombus measuring 71 cm in length - an exceptional finding rarely described in blunt vascular trauma. We report a case of a 59-year-old male who sustained trauma to the left groin from a motorcycle handlebar impact during a road traffic accident. He presented six hours after the incident with absent distal pulses and delayed capillary refill in the affected limb. Computed tomography angiography revealed complete non-opacification of the left common femoral artery and proximal superficial femoral artery over a 4.4 cm segment, suggestive of arterial thrombosis. Emergency surgical exploration confirmed the thrombus, which was successfully extracted using a Fogarty catheter. The contused arterial segment was resected, and a tension-free end-to-end anastomosis was completed using a 6-0 Prolene suture. Based on clinical assessment, the limb ischemia was classified as Rutherford Grade IIa, indicating a marginally threatened limb requiring prompt intervention. Postoperatively, limb perfusion was restored with no signs of ischemic complications, and the patient regained full function. At six-week follow-up, triphasic flow was confirmed on Doppler ultrasound. This case underscores the importance of maintaining a high index of suspicion for vascular injury in blunt trauma patients, particularly when skeletal injury is absent. Early diagnosis and timely surgical management are vital to prevent limb loss and ensure favorable outcomes.

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