Popliteal artery injury following fracture or dislocation at the knee

Dart, Charles H.; Braitman, Howard E.

doi:10.1097/00005373-197712000-00021

Cited by 5 publications

(5 citation statements)

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“…2 Although initial reports of popliteal artery repair involved debridement and primary reanastomosis, contemporary management calls for interposition grafting with autogenous great saphenous vein harvested from the contralateral extremity. [14][15][16][17][18] All open repairs of arterial injury in this series were treated in this fashion. This approach avoids the sacrifice of valuable geniculate collaterals required with the extensive popliteal artery mobilization necessary to perform a tension-free, end-to-end, primary anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

Georgiadis

Mohammad

Mizerik

et al. 2013

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

Georgiadis

Mohammad

Mizerik

et al. 2013

Journal of Vascular Surgery

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“…The need for routine angiography has been a source of debate. Some authors consider it to be mandatory 8,13,19,[28][29][30][31][32][33] while others think that it is necessary only in selected cases. 2,10,26,[34][35][36][37][38] The evidence in the literature suggests that routine angiography in all cases is not required.…”

Section: Discussionmentioning

confidence: 99%

Dislocation of the knee

Robertson

Nutton

Keating³

2006

The Journal of Bone and Joint Surgery. British volume

164

110

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“…The association of popliteal and other lower-extremity vascular injuries with blunt and penetrating trauma to the lower extremity is well described. [13][14][15][16][17][18] Popliteal arterial injuries, particularly disruptions and occlusive insults, represent a significant threat to limb viability in the traumatized patient. Debakey and Simeone, 4 in their seminal article detailing wartime experience with major-extremity arterial injuries, cited a 49% amputation rate with simple arterial ligation and a disastrous 73% with ligation of the popliteal artery, in particular.…”

Section: Commentmentioning

confidence: 99%

Blunt Lower-Extremity Trauma and Popliteal Artery Injuries

Abou-Sayed

Berger²

2002

Arch Surg

103

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Abandoning mandatory angiography in patients with blunt lower-extremity trauma and normal neurovascular examination results does not affect limb salvage.Design: Retrospective, nonrandomized cohort study. Mean follow-up (31 of 52 patients) of 9.5 months (range, 0-96 months).Setting: Single-institution, academic level I trauma center.Patients: Medical records of patients presenting emergently with knee dislocation, distal femoral fractures, or proximal tibial fractures during a 20-year period were reviewed. Fifty-three injuries occurred in 52 patients. Patients were predominantly male (81%) and young (mean age, 32.7 years). Mechanisms and side of extremity injury, coincident injuries, and neurovascular status on admission were recorded. Hard signs of arterial insufficiency or compartment syndrome were identified.Interventions: Angiographic findings and operative and nonoperative interventions were recorded to identify whether angiographic data would alter therapy dictated by clinical findings alone.Main Outcome Measures: Limb salvage rate and necessity for vascular surgical intervention based on an-giographic data in patients with normal neurovascular examination results.Results: Multiorgan trauma occurred in 11 patients. Pulses were normal in 35, absent in 16, and diminished or identified by Doppler signal in 2. Arterial insufficiency or compartment syndrome was present in 29%. Twenty-seven patients (28 limbs) underwent angiography at the discretion of the attending surgeon. Of 13 abnormal arteriograms, 2 occurred in patients with normal pulses and 11 in patients with abnormal examination results. Thirteen of 36 patients with normal pulses underwent angiography; none had clinically significant arterial injuries that necessitated intervention. No vascular interventions were necessary in 23 patients with normal pulses who did not undergo angiography (PϽ.001). Normal neurovascular status bore a 100% negative predictive value in determining the necessity of vascular intervention.Conclusions: Angiography is unnecessary in the routine evaluation of the patient with blunt lower-extremity trauma who presents with a normal neurovascular examination result and can be used selectively for patients with diminished pulses who lack associated indications for mandatory operative exploration.

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Popliteal artery injury following fracture or dislocation at the knee

Cited by 5 publications

References 0 publications

Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

Dislocation of the knee

Blunt Lower-Extremity Trauma and Popliteal Artery Injuries

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