Abstract
Purpose: Knee dislocation is associated with blunt popliteal artery trauma in almost 30% of cases. In such injuries, prompt diagnosis and appropriate management is essential for limb salvage. Both our methods and outcomes of popliteal artery thrombosis treatment after knee dislocation are presented in this retrospective study.
Methods: During the last six years, eight patients (all male, average age 25 years) were admitted to our hospital with knee dislocation and associated blunt popliteal artery thrombosis following automobile accidents (7/8) and fall from height (1/8). The average delay before accessing the emergency room was 14 hours (ranging from 2 to 24 hours). Seven patients were experiencing signs of distal ischemia (absence of distal pulses, motor and sensory loss) and one patient, admitted two hours after vehicle accident, was presented with absent distal pulses but maintained motor and sensory ability. Seven patients underwent external fixation and one plaster cast immobilization. In all cases, digital subtraction arteriography was performed.
Results: All patients were treated by performing below knee femoropopliteal bypass, using reversed saphenous vein in seven cases and a vscs graft in one. All patients underwent fasciotomies. One above knee amputation was performed postoperatively while three patients experience permanent neurologic discrepancy.
Conclusions: In any case of knee dislocation, there must be a high clinical suspicion of popliteal artery thrombosis. Meticulous and repeated physical examination and rapid admission to a department of vascular surgery are of vital importance for limb salvage and minimization of amputation rate and permanent neurologic deficiency.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
