Vascular injuries of the extremities: hazards of unnecessary delays in diagnosis.

Delay in the diagnosis of vascular injuries of the extremities is still considered acceptable practice by many, despite its inherent high risk of morbidity and permanent disability. Such practice must be discouraged, because vascular wounding can be diagnosed early and with great precision by angiography. The arteriogram should become part of the initial emergency room assessment of all patients who sustain penetrating injuries of the extremities, as well as those who suffer violent blunt extremity trauma.