Related Experiment Videos
Delayed presentation of traumatic popliteal artery pseudoaneurysms: a review of seven cases
J D Woolgar1, D S Reddy, J V Robbs
1Durban Metropolitan Vascular Service, Department of Surgery, Durban, South Africa.
Insights
Delayed presentation of traumatic popliteal artery pseudoaneurysms often results in large aneurysms and knee flexion deformities. Morbidity is linked to the severity of pre-operative knee flexion deformity, impacting patient outcomes.
Area of Science:
- Vascular Surgery
- Trauma Management
- Orthopedic Surgery
Background:
- Traumatic popliteal artery pseudoaneurysms (PAPs) can present with significant delay after initial injury.
- Delayed presentation is often associated with larger pseudoaneurysm size and potential complications.
- Fixed flexion deformity (FFD) of the knee is a recognized complication impacting limb function.
Purpose of the Study:
- To investigate the management strategies and clinical outcomes of patients with traumatic popliteal artery pseudoaneurysms presenting after a delay.
- To assess the correlation between delayed presentation, pseudoaneurysm characteristics, and functional outcomes.
Main Methods:
- Retrospective review of clinical records for 7 patients with traumatic PAPs presenting >1 month after injury.
- Analysis of injury mechanism, pseudoaneurysm size, degree of knee FFD, treatment, and outcomes.
- Data collected over a 2-year period at a tertiary referral unit.
Main Results:
- Median delay between injury and presentation was 1.5 months (range 1-24 months).
- Gunshot wounds were the primary cause of injury in 6/7 patients.
- All patients had large pseudoaneurysms (>8 cm) with varying degrees of knee FFD; 2 had severe FFD (>40 degrees).
- Six patients underwent pseudoaneurysm repair; one required above-knee amputation due to infection.
- Post-operative physiotherapy yielded limited improvement in FFD; only 2 patients achieved full leg extension at discharge.
Conclusions:
- Delayed presentation of traumatic popliteal artery pseudoaneurysms is associated with significant morbidity.
- The degree of pre-operative fixed flexion deformity of the knee is a critical factor influencing patient morbidity.
- Early diagnosis and management are crucial to prevent severe functional impairment.
Objectives:
to examine the management and outcome of patients with traumatic popliteal artery pseudoaneurysms with delayed presentation.
Materials:
over a 2-year period 7 patients with traumatic popliteal pseudoaneurysms presenting to a tertiary referral unit after a delay of 1 month were reviewed.
Methods:
a retrospective review of clinical records.
Results:
the median interval between injury and presentation was 1.5 months (range 1-24 months). Penetrating trauma from gunshot wounds was the cause of the initial vascular injury in 6 patients and a stab wound in one. All patients had large pseudoaneurysms of more than 8 cm filling the popliteal fossa with variable degrees of fixed flexion deformity (FFD) of the knee. Severe FFD of more than 40 degrees was noted in 2 patients and 3 others had mild flexion deformities of 10 to 20 degrees. Six patients underwent repair of the pseudoaneurysm. One patient required an above knee amputation due to an infected false aneurysm. There were no deaths or graft related complications. Despite aggressive post-operative physiotherapy only 2 patients were able to completely straighten the leg at the time of discharge.
Conclusions:
in patients with neglected popliteal artery pseudoaneurysms, morbidity is associated with the pre-operative degree of fixed flexion deformity of the knee.
Related Concept Videos
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:30Aneurysm I: Introduction