{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:43:13Z","timestamp":1777941793678,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T00:00:00Z","timestamp":1661040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Pilon fractures of the distal tibia are usually the result of a high-energy trauma and can affect seriously the arterial vasculature carrying an increased risk of amputation at the malleolar level or higher. Such cases represent a challenge for the orthopedic surgeons and a multidisciplinary approach is mandatory in order to salvage the threatened limb. We present an unusual case of a closed pilon fracture with injury of all tibial vessels leading to acute limb threatening ischemia. The patient was treated successfully with external fixation and a short tibial-pedal bypass with use of an autologous reversed saphenous vein graft. This example dictates how a distal leg fracture can be dramatic and that awareness of vascular examination coupled with high suspicion of vascular damage can be limb-saving. Multidisciplinary approach is warranted since the topology and complexity of the ankle lesions necessitate staged orthopedic reconstructions with tibio-distal bypass and appropriate skin coverage of the distal anastomosis.<\/jats:p>","DOI":"10.1177\/15385744221116844","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T02:41:10Z","timestamp":1661136070000},"page":"64-68","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Anterior Tibial to Dorsalis Pedis Bypass to Manage Acute Ischemia Attributed to Pilon Fracture"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3789-1110","authenticated-orcid":false,"given":"Efstratios","family":"Georgakarakos","sequence":"first","affiliation":[{"name":"University Hospital of Alexandroupolis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Papatheodorou","sequence":"additional","affiliation":[{"name":"University Hospital of Alexandroupolis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthimos","family":"Keskinis","sequence":"additional","affiliation":[{"name":"Democritus University of Thrace"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-1512","authenticated-orcid":false,"given":"Georgios I","family":"Karaolanis","sequence":"additional","affiliation":[{"name":"University Hospital of Ioannina, School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paraskevas","family":"Georgoulas","sequence":"additional","affiliation":[{"name":"Democritus University of Thrace"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.764232"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.04.064"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2014.01.001"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620913705"},{"issue":"5","key":"e_1_3_3_6_2","first-page":"651","article-title":"Popliteo-distal and tibio-tibial bypasses: A viable alternative for the revascularisation of the critically ischaemic limb","volume":"42","author":"Mo\u00f1uxDucaj\u00fa G","year":"2001","unstructured":"Mo\u00f1uxDucaj\u00fa G, Serrano Hernando FJ, Sanchez Herv\u00e1s L. Popliteo-distal and tibio-tibial bypasses: A viable alternative for the revascularisation of the critically ischaemic limb. 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