Original ArticlesPopliteal artery injuries: Civilian experience with sixty-three patients during a twenty-four year period (1960 through 1984)*
Section snippets
Patients
Sixty-three patients with injuries of the popliteal artery were admitted to the Health Sciences Centre (formerly Winnipeg General Hospital) during the past 24 years. The study comprised 53 male and 10 female patients, ranging in age from 10 to 73 years with 82% between 10 and 40 years of age. Fifty-three patients sustained blunt injuries and 10 patients suffered penetrating injuries (Table I).Empty Cell No. % Blunt with skeletal lesion 44 70 Blunt without skeletal lesion 9 14
Associated skeletal injury
Skeletal trauma accompanied the arterial injury in 49 of the 63 patients (Table III).Empty Cell No. Amputation % Knee dislocation 12 4 33 Knee dislocation with femoral shaft fracture 1 — — Knee dislocation with femoral and tibial shaft fractures 1 1 — Knee dislocation with tibial plateau and fibular fractures 3 — — Knee dislocation with fracture fibula 1 1 — Upper tibia and fibula fractures 20 9 45 Upper tibia and fibula with femoral shaft fractures 2 — — Femoral supracondylar
Repair and results
Four patients died, resulting in a mortality rate of 6.3% (Table V).Empty Cell No. Occlusions AmputationsDeaths Deaths Direct anastomosis 19 0 0 2 Vein graft 35 5 11 1 Prosthesis 3 1 2 1 Lateral repair 1 — — — No repair 5 — 5 — Total 63 6 18 4
Discussion
Popliteal artery occlusions associated with skeletal trauma caused by blunt injury continue to result in serious morbidity and high amputation rates. Delayed recognition of the arterial lesion is the major cause of these poor results. Our series includes 18 knee dislocations, most of which were reduced before the patient was admitted to the hospital. The magnitude of the injury and the potential for vascular disruption is frequently not suspected at the initial examination. This failure to
Summary
Our experience with 63 popliteal artery injuries has been reviewed. The single most important factor in successful management is early recognition and early repair. When repair is accomplished within 6 hours, the results are as good as those achieved with other arterial injuries. Dislocation of the knee is more common than frequently reported. Capillary-skin blood flow is not a reliable method of assessing the adequacy of the circulation. When a popliteal artery injury is suspected, it must be
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Reprint requests: A. R. Downs, M.D., F.R.C.S.C., Department of Surgery, University of Manitoba and Health Sciences Centre, 700 William Ave., Winnipeg, Manitoba, Canada R3E 0Z3.