Outcome of Popliteal Artery Injury in Ibn Al Nafees Hospital Jassim Mohammed Mahdy* FIBMS, Hammood Naser Mohsin** FIBMS, Talat Rifat Rahman*** FIBMS
Abstract
Background: Popliteal artery injury is the most common cause of amputation in extremities. Blunt trauma was the most frequent cause of injury, however penetrating trauma injuries are considerable.
Objectives: To focus on the way of presentation, modes of management and sequel of repair popliteal artery injury.
Methods: This is a retrospective study of 80 patients, presented with popliteal artery injury admitted to Ibn-Al-nafees teaching hospital from January 2015 to December 2015. Patients were classified into 4 groups depending on their hemodynamic state, group A 18 75%, group B 16.25%, group C 46 25% and group D 18.75% and their diagnosis depended on clinical presentations mainly hard signs and soft signs without using duplex or angiography because of their unavailability at time of reception.
Results: Resection and graft interposition using saphenous vein was done in the majority of cases with the use of heparin locally and/or systemically in most of the cases. Associated popliteal vein injury constituted 70% of associated injuries, which must be repaired when feasible to avoid amputation because ligation was an aggravating factor for amputation. Fracture of femur represent 40% of associated injuries and represents a dilemma in the management in which fracture stabilization performed before arterial repair unless limbthreatening ischemia was found and the procedure must not encroach on the viability of the limb. Fasciotomy was indicated and it was performed in most of the cases.
Conclusion: Lifesaving, which is the primary goal of surgery of popliteal artery injury followed by limb salvage still can be achieved if repair done within 9 hours of injury.
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