Popliteal Artery Injury

 The popliteal artery is the second most commonly injured vessel in the lower limb.1 Ischemia of the lower limb caused by popliteal artery injury (PAI) is one of the major causes of lower extremity morbidity associated with poor rates of limb salvage.2,3 In instances of blunt trauma, PAIs are associated with fracture mechanisms, concomitant soft tissue injury, and posterior knee dislocation causing traction or avulsion of the vessel. This commonly leads to high rates of limb amputation and significantly worse outcome. Penetrating injuries are less common and tend to have a better outcome, with limb salvage rates of up to 84%.2-5 Although most of the published data focus on amputation rates, the difference in functional outcome among patients with PAI caused by blunt or penetrating trauma have not been described well. This study assessed the amputation rate and, subsequently, the therapeutic management and the clinical outcome regarding the affect of concomitant injuries among patients with PAI in setting of central European trauma care. The study was approved by the local ethic committee and was done in accordance with the Declaration of Helsinki. All patients gave informed consent. Study design and patient recruitment. We retrospectively analyzed prospectively collected data for all patients treated with PAI at our level I trauma center. A sample of 89 patients with PAI caused by blunt or penetrating trauma treated between January 1999 and December 2009 was sorted, and their data set was examined for completeness and accuracy. From this sample we excluded two patients who had undergone previous surgery of the ipsilateral lower limb arteries, 11 who had received primary surgical treatment before being transferred to our department, and 12 patients with an incomplete data set. The study sample comprised 64 patients (20 female, 44 male) with an average age of 44 years (range, 17-79 years) at time of injury, who were evaluated for clinical characteristics, concomitant injuries, complications amputation rates, and functional outcome after traumatic PAI. All patients attended standard follow-up visits in our outpatient clinic at 12 months after the injury.