After a fracture, the injured limb should not be moved at will to avoid secondary injury to the fracture site, i.e. re-injury to the adjacent blood vessels, nerves and soft tissues due to displacement of the fracture end. It is best to call 120 to the scene for treatment when available, and temporary fixation/braking of the fractured lower leg should be carried out on site. If the fracture is open, the wound can be dressed with a clean gauze dressing, and then temporarily immobilised, and then transported to the nearest emergency trauma centre by specialist first aid personnel for subsequent specialist diagnosis and follow-up treatment.
After transport to the hospital, a routine history taking, physical examination and imaging will be carried out, inquiring about the cause of the injury, the local condition of the fracture, the movement and sensation of the injured limb, the presence of other combined injuries, and a routine X-ray examination of the injured lower leg.
In cases where arterial injury is suspected, vascular ultrasound is performed promptly and if the diagnosis is still not clear, DSA is performed if necessary. However, there are still limitations to the clinical use of DSA, such as the fact that it is an invasive test that requires repeated lifting of the patient, which is inconvenient for patients with multiple injuries throughout the body, the fact that the test is time-consuming and may delay treatment, and the fact that primary hospitals may not have DSA equipment.