Occult femoral artery injury in a case of closed fracture of the femur revealed during guillotine above-knee amputation: a case report

Arterial injury is most commonly seen with penetrating injuries. An arterial disruption in a closed fracture is rare. It has been reported in only 0.3% of long bone fractures. The authors report a case of femoral artery injury in a polytrauma patient associated with a closed femoral fracture. The arterial injury was not apparent until the patient had an above-knee guillotine amputation done to revise his ipsilateral below-knee traumatic amputation, which released the soft -tissue tamponade effect on the leak. Unless the possibility of this injury is kept in mind, above-knee amputation or any other open procedure on a patient with a femoral fracture can cause exsanguination of the patient.