Popliteal Artery Injury Associated with Blunt Trauma to the Knee without Fracture or Dislocation

Abstract

Popliteal artery injuries are frequently seen with fractures, dislocations, or penetrating injuries. Concern about arterial injury and early recognition of the possibility of arterial injury is crucial for the salvage of the extremity. This article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating injury, knee dislocation, fracture, or high-velocity trauma mechanism. The importance of a detailed vascular examination of a blunt trauma patient is emphasized.

Nonatherosclerotic Peripheral Artery Disease

“…Orthopedic surgery or trauma may cause lower limb ischemia because of dissection or thrombotic occlusion [87]. Additionally, pediatric cardiac catheterization using the transfemoral approach could be a cause of iliofemoral occlusion or stenosis due to thrombosis formation or intimal hyperplasia (Figure 14).…”

Pitfalls in Distal Femur Fracture Fixation and a Literature Review

“…If it is an open fracture, antibiotic therapy, tetanus prophlaxy, timtiming of the fracture fixation and appropriate device may be changed by this fact (23). Vascular supply to extremity should be cleared and checked before operation (24). Missing time in the presence of vascular injuriy may end in amputation.…”

Cold Limb in Blunt Knee Injury

“…The mechanisms of blunt PA injuries are secondary to posterior knee dislocation with traction, vascular avulsion, or bony fragments of complex tibial plateau or supracondylar femur fractures [1][2][3][4]. The PA injuries associated with blunt trauma have transection, occlusion, laceration, perforation, arteriovenous fistula, or intimal injury [2][3][4]. Vascular injury can have devastating consequences in patients, as irreversible ischemia can occur in as short as 6 to 8 hours [2,5].…”

“…The PA injuries associated with blunt trauma have transection, occlusion, laceration, perforation, arteriovenous fistula, or intimal injury [2][3][4]. Vascular injury can have devastating consequences in patients, as irreversible ischemia can occur in as short as 6 to 8 hours [2,5]. Hard signs of PA injuries, including a pulsatile expanding hematoma, absence of pulse, presence of bruit or thrill, and ischemia of distal limbs, require emergency surgical intervention [1,5].…”

“…Early diagnostic images, including MDCT and digital substrate angiography which can confirm the location and severity of vascular injury, with vascular repair are recommended for limb-saving. An endovascular stent offers an alternative modality to traditional surgical repair [1][2][3]5].…”