Popliteal artery and trifurcation injuries: Is it possible to predict the outcome?

Lazarides, Miltos K.; Arvanitis, Dimitrios P.; Kopadis, George C.; Tsoupanos, Spyros S.; Dayantas, John N.

doi:10.1016/s0950-821x(05)80465-7

Cited by 16 publications

(6 citation statements)

References 19 publications

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“…Die Amputationsrate an dem von uns vorgestellten Patientengut liegt mit 2,6 % niedrig. Vergleichbare Untersuchungen an Patienten mit ähnlichen Verletzungsmustern berichten über Amputationsraten von über 18 % bei kombinierten Extremitätenverletzungen mit Gefäûbeteiligung[12,18,19]. Wir führen diese Tatsache, neben der schnellen Zugriffszeit des Notarztsystems, insbesondere auf die Effektivität des interdisziplinären Zusammenspiels der verschiedenen Fachdisziplinen von Chirurgie, Unfallchirurgie, Gefäûchirurgie, Anästhesie und Radiologie zur Verringerung der Ischämiezeit zurück.Die allgemeine Prognose bei Verletzungen der Extremitäten mit Beteiligung des Gefäûsystems hängt von der zügigen und suffizienten Diagnostik und Therapie ab.…”

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Gefäßverletzungen nach Extremitätentrauma

Ockert¹,

Winkler²,

Richter³

et al. 2002

Zentralbl Chir

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The aim of the present examination was to analyse extremity trauma with additional vascular injuries. Between 1973-2000 78 patients with traumatic peripheral vascular injuries have been treated at the Surgical Department of the University Hospital of Mannheim. In addition to clinical examination Doppler-Duplex ultrasonography (cw-Doppler) was routinely performed. In selected cases either conventional or magnetic resonance angiography completed the diagnostic procedure. Vascular injuries to the upper extremities were found in 46.2 % (n = 36) whereas 53.8 % (n = 42) of the patients suffered from trauma of the lower extremities. The popliteal artery was affected in 28.2 % followed by the brachial artery with 23.1 %. 52.6 % of the patients had interposition of autologous vein for reconstruction. Only 7.7 % of the cases needed interposition of alloplastic material. In general the injured extremity was immobilised by external fixation, followed by secondary vascular reconstruction. An efficient trauma management reduced amputation rate as low as 2.6 %.

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Gefäßverletzungen nach Extremitätentrauma

Ockert¹,

Winkler²,

Richter³

et al. 2002

Zentralbl Chir

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“…The diameter of the medial sural artery is an average of 2 mm, not significantly different from that of the peroneal artery, and its use as the recipient artery in lower extremity bypass procedures demonstrates its noteworthy clinical value. 5,6 Although the 2 patients presented in this report had a low score using objective criteria predicting primary amputation, 7 both lost limbs. Both patients suffered refractory calf sepsis, and 1 suffered sudden exsanguination from disruption of the arterial anastomosis.…”

Section: Discussionmentioning

confidence: 75%

The Significance of Medial Sural Artery Integrity in Popliteal Artery Trauma: A Case Report

Tzilalis

Georgiadis

Papas

et al. 2005

The International Journal of Lower Extremity Wounds

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Two patients with popliteal artery trauma who underwent secondary amputations due to refractory calf sepsis despite a patent arterial repair are presented in this case report. The medial sural artery, the main arterial supply of the medial head of the gastrocnemius, was surgically severed in both patients owing to the use of a continuous medial incision from the supra level to infragenicular level. The compromised arterial supply of the medial head of the gastrocnemius muscle may have contributed to the devitalization of the muscle and the subsequent calf sepsis, and it is speculated that this was related to the unfavorable outcome.

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“…21 However, in general, there is a precipitous decline in lower extremity limb preservation when treatment occurs more than 24 hours after vascular occlusion. 8,16,18,24,26,28,32 …”

Section: Discussionmentioning

confidence: 99%

Death After Closed Adolescent Knee Injury and Popliteal Artery Occlusion

2013

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A healthy adolescent male soccer player sustained a radiograph-negative, effusion-negative physeal injury of the proximal tibia from a ground-level fall with traumatic occlusion of the popliteal artery. Orthopaedic evaluation and arteriography were delayed for 72 hours after the injury. He arrived at a tertiary referral center in multisystem organ failure secondary to lower extremity ischemic necrosis, septic pulmonary thromboembolism, and systemic shock. Emergent medical evaluation, a high index of suspicion, and a careful neurovascular examination are imperative after every closed knee injury in the young athlete.

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Popliteal artery and trifurcation injuries: Is it possible to predict the outcome?

Cited by 16 publications

References 19 publications

Gefäßverletzungen nach Extremitätentrauma

Gefäßverletzungen nach Extremitätentrauma

The Significance of Medial Sural Artery Integrity in Popliteal Artery Trauma: A Case Report

Death After Closed Adolescent Knee Injury and Popliteal Artery Occlusion

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