Extensive Iliofemoral Intimal Injury after Handlebar Trauma Requiring Iliac Exposure and Saphenous Vein Interposition Grafting: A Case Report.

Blunt trauma caused by bicycle or motor-scooter handlebars is a rare mechanism of femoral artery injury. Three-wheelers, commonly operated with handlebars, are a frequent mode of transportation in Sri Lanka. This case report describes a 22-year-old male driver of a three-wheeler who presented with acute occlusion of the common femoral artery (CFA) after blunt handlebar trauma to the groin during a collision. Intraoperatively, the intimal injury extended from the CFA to the external iliac artery, necessitating iliac exposure and reconstruction with a reversed great saphenous vein interposition graft. Arterial perfusion was successfully restored. Although the postoperative course was complicated by iliofemoral deep vein thrombosis, limb salvage was achieved. This case highlights that handlebar trauma to the groin can result in arterial injury extending beyond the site of impact. Clinicians managing such injuries should be prepared to extend exposure to the iliac vessels and perform appropriate reconstruction when needed.