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Popliteal artery injury associated with knee dislocations
D Martinez1, K Sweatman, E C Thompson
1Department of Cardiovascular Surgery, Wake Forest University Medical Center, Winston-Salem, North Carolina, USA.
The American Surgeon
|March 13, 2001
Summary
Knee dislocations with normal pulses do not require arteriograms, as they rarely show injuries. Arteriograms are crucial for patients with diminished or absent pulses to detect popliteal artery injuries.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Trauma Care
Background:
- Knee dislocations are frequently associated with popliteal artery injuries.
- The necessity of routine arteriography in all knee dislocation cases has been questioned.
Purpose of the Study:
- To determine if arteriography is necessary for all patients presenting with knee dislocations.
- To evaluate the utility of arteriography based on peripheral pulse examination findings.
Main Methods:
- Retrospective chart review of 21 patients with knee dislocations.
- Analysis of arteriogram results correlated with peripheral pulse examination.
- Assessment of subsequent surgical intervention and complications.
Main Results:
- Nine of 12 patients (75%) with normal palpable pulses underwent arteriography, revealing only one intimal defect.
- None of the patients with normal pulses required surgery, and no complications arose from nonoperative management.
- All patients with diminished or absent pulses underwent arteriography, with 55% showing abnormalities and two requiring surgical repair.
Conclusions:
- Arteriography is not beneficial for patients with knee dislocations who have normal peripheral pulses.
- Routine arteriography in knee dislocations with normal vascular examination does not improve patient outcomes.
- Peripheral pulse assessment is a reliable initial screening tool for popliteal artery injury in knee dislocations.
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