Popliteal artery injury: Royal Perth experience and literature review

Yahya, Mazri; Mwipatayi, Bibombe P.; Abbas, Manzoor; Rao, Suhakar; Sieunarine, Kishore

doi:10.1111/j.1445-2197.2005.03550.x

Cited by 33 publications

(25 citation statements)

References 42 publications

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“…The popliteal artery, because of its attachments both proximal and distal to the knee, is injured in approximately 20% to 40% of all knee dislocations [3, 4]. The incidence can be as high as 50% [5] in anterior and posterior dislocations [6] and higher with co-existing fractures [7]. Vascular status can be established clinically or through an angiography.…”

Section: Introductionmentioning

confidence: 99%

“…Duplex Doppler Ultrasound has been found to be equally as accurate in the elective setting. The accuracy however decreases with skeletal deformity, swelling, haematoma, dressings, and the lack of necessary skill and expertise [7]. Normal vascular examination and observation has been found to be sensitive enough to exclude vascular compromise [8].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Operatively Treated Acute Knee Dislocations

Eranki¹,

Begg²,

Wallace³

2010

TOORTHJ

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Knee dislocation is a complex and rare injury often presenting in the context of high velocity trauma. The aim of this study is to establish the subjective outcomes of surgically treated knee dislocations. A total of 20 knees dislocations treated by open repair were reviewed. Their progress and outcomes were assessed by using a modified Lysholm score questionnaire. Data was obtained on patient demographics, details of injury, investigation, treatment, rehabilitation, 24 months objective outcome and subjective outcomes. Six patients had a vascular deficit and six had neurological deficits. The median range of motion was 0°-100°. Patients with an initially lower pre-injury level of function were able to return an activity level comparable to their pre-injury status. 22% of competitive athletes retuned to competitive sports. 38% of patients undertaking heavy activity returned to comparable pre-injury level of activity and 67% of patients undertaking moderate level of activity before injury returned to a comparable level after repair. 68% regularly had problems running, 70% problem squatting, 40% swelling and 42% problem with stairs. Most patients however did not have locking of the knee or problems with knees giving way. Patients pain scores decreased over time to an acceptable level. Despite the severity of the injury, majority of patients achieved a satisfactory outcome, although none of the patients reached the same level of function as before the injury. 80% of the patients were satisfied with their outcome. All dissatisfied patients suffered postoperative complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of Operatively Treated Acute Knee Dislocations

Eranki¹,

Begg²,

Wallace³

2010

TOORTHJ

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“…The rate of amputation in our study was 11.4%, while the rate of amputations after femoropopliteal vascular traumas has been reported up to 36% [15][16][17] . In study by Saeed et al, 30% of the injured persons underwent amputation 18 and in study by Davoodi et al 34% of patients have been amputated 19 and this shows that amputations in our study compared to other similar studies has been at the possible lowest rate.…”

Section: Discussionmentioning

confidence: 83%

Outcomes of Femoro-Popliteal Vascular Trauma Surgery: A Three-Year Survey (2011-2013) in Ahvaz Golestan Hospital (Iran)

Nazari¹,

Mashhadi²,

Alamshah³

et al. 2015

Biosci., Biotech. Res. Asia

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Popliteal artery injury is one of the peripheral vascular injuries, is a major cause of disability to maintain the damaged limb, and orthopedic injuries are its most common cause. This study aimed to investigate the effects of femoro-popliteal vascular injuries surgery and discover probable defects and weaknesses during the evaluation and treatment of patients to mitigate the effects of disability. This descriptive and analytical study retrospectively and prospectively evaluates the outcomes of femoro-popliteal vascular trauma surgery in fifty-four patients referred to Ahvaz Golestan Hospital during September 2011 to May 2013. The patients were evaluated for average time of ischemia, trauma mechanism, combined damages, vascular repair techniques, postoperative complications, recovery rate of fasciotomies, rate of recovery, and amputation rate. The data were analyzed using the independent t-test and Fisher's exact test and P<0.05 was considered as significant. The mean age of the 44 patients was 27.7 ± 12 years that 86.4% of them were men and 13.6% were female and 72.7% of patients were referred from the different counties of Khuzestan province to this center and the rest were from the provincial capital, Ahvaz. In 63.6% of patients, trauma mechanism was blunt and in the rest was penetrating. The most common combined injuries were bone fractures, and the most common vascular repair method was the saphenous vein interposition graft. Furthermore, 40.9% of victims underwent a fasciotomy that 72.2% were fully recovered. The average time of ischemia (from incident to reperfusion) was 26.1 ± 24.6 hrs. Although the majority of subjects (72.72%) was referred from the various cities of the province and caused to longer average time ischemia (from the accident until reperfusion), recovery rate after vascular repair surgery was 88.6%, and only five patients (11.4%) were amputated. Therefore, the long time average of ischemia (from the accident until reperfusion) alone cannot cause vascular remodeling or failure to perform an amputation. The multiple combined damages, including damage to the vein could have an important role in the amputation of a limb so that vein damage ratio did no show significant differences in two amputee and recovered groups (p = 0.008).

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“…6 On-table angiography has been shown to prevent delays associated with formal angiography, 3,9 which should be reserved for patients with reasonable distal perfusion in whom the diagnosis of arterial injury is in doubt. 24 The sequence of revascularisation and external fixation in this study group appeared to have no association with limb loss. While the timing of stabilisation of fractures in the context of vascular injury is contentious, 1,2,6 a meta-analysis has demonstrated no difference in the amputation rates in patients undergoing vascular repair prior to stabilisation versus those undergoing stabilisation prior to vascular repair.…”

Section: Delayed Amputation 10 33%mentioning

confidence: 96%