PRESENTING FEATURES AND SURGICAL OUTCOME OF POPLITEAL ARTERY TRAUMA IN A CIVILIAN SET-UP

Abstract

Popliteal artery injuries are mainly seen in military experience. This study was undertaken in a civilian vascular surgical unit with a large trauma workload dealing with traffic accidents. A retrospective review of patients treated between 1995 and 2001 was undertaken. 145 cases of popliteal artery injuries were treated. These cases included 46.89% compound and lacerated injuries due to traffic accident, 24.82% blunt trauma and 6.20% of iatrogenic nature. Associated fractures occurred in 14 (9.65%) patients and 19.34% had popliteal vein injuries. Treatment of the arterial injury included vein graft inter-position in 101, primary reanastomosis in 28, prosthetic graft interposition in six, lateral suture in 12, vein patch in five and ligation in one. Eithy four fasciotomies were performed. No perioperative death occurred. There were 9 primary and 11 secondary amputations. Factors associated with amputation were compound and lacerated injuries, delay in revascularization in excess of 7 hours, arterial transection, associated fracture, and compartment syndrome or muscle infarction. Usually the traffic accident trauma leading to popliteal artey injuries is associated with a high amputation rate. Prompt resuscitation and revascularization appear to be the only factors that may improve limb salvage rates.;