ПО другому питанню: кістка -судини -нерв, краще почати шунтування, але легше казати, ніж зробити.
That the patient will need surgery is clear, but the issue here is what to do first. A very delicate
vascular repair, and an even more fragile nerve reanastomosis, would be at risk of disruption
when the orthopedic surgeons start manipulating, hammering, and screwing the bone.
Thus the usual sequence begins with fracture stabilization, then vascular repair (both artery
and vein if possible), and last nerve repair. The unavoidable delay in restoring circulation will
make a fasciotomy mandatory. Temporary shunting the arterial injury to allow distal perfusion
is a good solution if offered as a choice, but is easier said than done in real life.