Spontaneous popliteal vascular injury in the morbidly obese

Hagino, Ryan T.; DeCaprio, Jeffrey D.; Valentine, R. James; Clagett, G. Patrick

doi:10.1016/s0741-5214(98)70131-4

Cited by 62 publications

(42 citation statements)

References 17 publications

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“…This is a clinical entity whose presentation, treatment, and complications have been described at a few major centers and that seems associated exclusively with obesity. [7][8][9][10] Knee dislocation is defined by loss of the tibiofemoral articulation. Traditionally, high-velocity dislocations result from vehicular trauma and are associated with the highest rates of nerve and vascular injury, while low-velocity dislocations are characterized as sports injuries.…”

mentioning

confidence: 99%

“…Rates of operative vascular injury range from 15% to 100%, 7,9,17,18 with similarly high rates of tibial and peroneal neurapraxia; these rates may exceed those of high-energy KD. After ligamentous reconstruction, patients with ULV KD have experienced more reoperations, thromboembolism, vascular claudication, and wound infections than patients who have sustained KD by another mechanism.…”

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confidence: 99%

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Beware of Ultra-Low-Velocity Knee Dislocation

Georgiadis¹,

Guthrie²,

Shepard³

2014

Orthopedics

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confidence: 99%

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confidence: 99%

Beware of Ultra-Low-Velocity Knee Dislocation

Georgiadis¹,

Guthrie²,

Shepard³

2014

Orthopedics

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“…The risk of vascular injury after a "spontaneous" lowvelocity knee dislocation (LVKD) in morbidly obese patients has been reported to be as high as 100% [1]. This stands in clear contrast to high-velocity knee dislocation (HVKD) associated to motor vehicle accidents in which a popliteal artery injury is "merely" found in about 19% of cases [2].…”

Section: Discussionmentioning

confidence: 99%

Fatal Knee Dislocation in a Morbidly Obese Jehovah’s Witness. A Case Report

et al. 2008

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“…Knee dislocations are traditionally divided epidemiologically into those caused by high velocity trauma such as an MVA (motor vehicle accident) or low velocity trauma such as those sustained in sporting injuries [6,7]. More recently there has been an increasing number of reports of knee dislocations involving morbidly obese patients [6,[22][23][24][25]. An increase in LVKD in the morbidly obese from 17% between 1995-2000 to 53% in 2007-2012 was reported by Georgiadis [24].…”

Section: Introductionmentioning

confidence: 99%

Vascular Injury in Obese Patients after Ultra-Low-Velocity Trauma

Fuchs¹,

Allmayer²,

Schweighofer³

et al. 2014

J Anesth Clin Res

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Background: Traumatic Knee Dislocation (KD) is a serious and potentially limb threatening injury, albeit a relatively rare condition. Knee dislocation, defined as a complete disruption of the integrity of the tibia-femoral articulation, is uncommon, representing 0.001% to 0.013% of orthopedic injuries. Male:Female ratio is 4:1, and nearly 10% are caused by ultra-low-velocity dislocations. These injuries have historically been attributed to High Velocity Impacts (HVKD) however more recently they are being noted in Low Velocity Incidents (LVKD), particularly involving morbidly obese people. An increase in LVKD in the morbidly obese from 17%, between 1995-2000 to 53% in 2007-2012 was reported in the literature. Methods:In our case series of two female patients vascular injury occurred after an ultra low velocity trauma in the domestic environment. Case 1 was a 72-year old female, BMI 28 kg/m 2 , with diabetes mellitus Type II, arterial hypertension, and obesity. Case 2 was a 57-year old female, BMI 44 kg/m 2 , with diabetes mellitus Type II, psychosis, and obesity. Vascular surgery was performed to maintain blood supply for the injured limb. Results:In one case full weight-bearing was achieved and the other case resulted in an above the knee amputation, due to severe soft tissue damage. Conclusion:Knee dislocation is a rare albeit a serious and potentially limb threatening condition. Expediancy in reducing the acutely dislocated knee is vital to prevent neurovascular damage and potential for compartement syndrome and limb amputation. Based on our observation, the knowledge of potentially serious adverse outcomes in obese patients with ultra-low-velocity trauma and vascular injury should increase our awareness in these patients with knee pain even after marginal trauma. X-rays, and if suspicion is raised, a CT-scan usually leads to a detailed and profound diagnosis, enabling immediate surgical intervention to save the affected limb.

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Spontaneous popliteal vascular injury in the morbidly obese

Abstract: Morbid obesity is a specific risk factor for spontaneous KD and vascular injury. In addition, morbid obesity presents unique challenges to operative repair and predisposes patients to unusual major postoperative complications.

Cited by 62 publications

References 17 publications

Beware of Ultra-Low-Velocity Knee Dislocation

Beware of Ultra-Low-Velocity Knee Dislocation

Fatal Knee Dislocation in a Morbidly Obese Jehovah’s Witness. A Case Report

Vascular Injury in Obese Patients after Ultra-Low-Velocity Trauma

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