Civilian popliteal artery injuries

  • Mohammed Asif Banderker Trauma Centre, Groote Schuur Hospital and University of Cape Town
  • Pradeep Harkison Navsaria Trauma Centre, Groote Schuur Hospital and University of Cape Town
  • Sorin Edu Trauma Centre, Groote Schuur Hospital and University of Cape Town
  • Wanda Bekker Trauma Centre, Groote Schuur Hospital and University of Cape Town
  • Andrew J Nicol Trauma Centre, Groote Schuur Hospital and University of Cape Town
  • Nadraj Naidoo Vascular Surgery, Groote Schuur Hospital and University of Cape Town

Abstract

Background. Civilian popliteal artery injuries are associated with significant amputation rates. Aim. The aim of this study was to identify factors associated with limb loss in patients with popliteal artery injuries. Patients and methods. We performed a retrospective chart review of prospectively collected data on patients with popliteal artery injuries presenting to the Trauma Centre at Groote Schuur Hospital, Cape Town, from 1 January 1999 to 31 December 2008. Demographic data, mechanism of injury, haemodynamic status, limb viability, special investigations, associated injuries, ischaemic time, surgical treatment and amputation rates were analysed. Results. One hundred and thirty-six patients with popliteal artery injuries were identified. Penetrating and blunt trauma accounted for 81 (59.6%) and 55 (40.4%) injuries, respectively. Associated injuries included fractures in 66 patients (48.6%), knee dislocations in 29 (21.3%) and popliteal vein injuries in 59 (43.4%). Fifty-seven patients (41.9%) presented with a compartment syndrome. Arterial injuries were treated with reversed vein grafting in 68 patients, primary anastomosis in 33, prosthetic graft insertion in 11, and primary amputation in 7. Thirty-two patients underwent delayed amputation, giving an overall amputation rate of 37.5%. A delay of more than 7 hours of ischaemic time between injury and definitive repair (p=0.0236) and the presence of a compartment syndrome (p=0.003) were significantly associated with an increased amputation rate. Conclusion. The most significant factors associated with the high amputation rate of 37.5% were an ischaemic time longer than 7 hours, and the presence of a compartment syndrome.
Published
2012-11-12
How to Cite
Banderker, M., Navsaria, P., Edu, S., Bekker, W., Nicol, A., & Naidoo, N. (2012). Civilian popliteal artery injuries. South African Journal of Surgery, 50(4), 119-124. https://doi.org/10.7196/sajs.1257
Section
General Surgery