Fig. 3

Extremity fractures with associated vascular damage. 3D-reconstruction (a) of the initial CT of a patient after motorcycle accident with closed femoral shaft fracture and disruption of the superficial femoral artery (★) with active bleeding palpable as pulsatile femoral mass (signal loss of soft tissue contrast agent pooling due to 3D-reconstruction sequence). Of note, fracture lines (a) indicate medial translocation of the osseous fragment towards the artery, probably causative of arterial rupture. Initial treatment included immediate open arterial reconstruction with vein graft interposition and external stabilization and after 12 days intramedullary nail repair (b). CTA with active pooling of contrast agent (*) from the brachial artery in a patient after fall with a grade IIIb open fracture of the humeral shaft (c). Initial treatment included patch plasty of the brachial artery, external fixation and fasciotomy of the forearm compartments. After 10 days the elbow joint was reconstructed with open reduction and plate fixation, an olecranon osteotomy was performed for better joint visualization