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Limb deformity with vascular compromise — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementLimb deformity with vascular compromiseDipIMC

A 19-year-old rider has a mangled ankle after being thrown from a horse. The foot is pale and pulseless, but the patient is alert and haemodynamically stable after analgesia. What is the most appropriate management?

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Correct answer: C — Gently realign the limb to restore perfusion, reassessing distal pulses afterwards

A grossly deformed limb with distal neurovascular compromise should be gently realigned by trained clinicians to improve perfusion, with careful reassessment before and after. Leaving the limb in the position found risks prolonged ischaemia. A tourniquet is for life-threatening haemorrhage, not an isolated pulseless foot without bleeding. The pearl is that neurovascular compromise changes splinting from comfort care to limb-saving intervention.

Reference: JRCALC Guidelines 2025; ATACC