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Injury to the popliteal vessels: the Lebanese war experience
R E Sfeir1, G S Khoury, F F Haddad
1American University of Beruit Medical Center, Lebanon.
World Journal of Surgery
|November 1, 1992
Summary
Popliteal vessel injuries often involve both arteries and veins, with fractures increasing amputation risk. Prompt surgical repair and specific interventions significantly improve limb salvage rates.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Orthopedic Surgery
Background:
- Popliteal vessel injuries are severe trauma with high limb loss risk.
- Associated injuries, including fractures and combined arterial/venous damage, complicate treatment.
- Optimal management strategies for these complex injuries require further elucidation.
Purpose of the Study:
- To report outcomes of surgical repair for popliteal vessel injuries.
- To identify factors influencing limb salvage in patients with popliteal vessel trauma.
- To evaluate the effectiveness of specific surgical interventions.
Main Methods:
- Retrospective review of 118 patients undergoing surgery for 178 popliteal vessel injuries.
- Analysis of injury patterns, including arterial, venous, and combined injuries, and associated fractures.
- Correlation of treatment modalities (arterial/venous repair, external fixation, fasciotomy) with limb salvage outcomes.
Main Results:
- 11.9% amputation rate (14/118 patients) with no reported deaths.
- 49% of injuries involved both artery and vein; 44% had associated bony fractures.
- Delayed repair (>6 hours), fractures, and shock were linked to increased limb loss.
Conclusions:
- Timely surgical intervention is crucial for popliteal vessel injuries.
- Combined arterial and venous repair, external skeletal fixation, and fasciotomy improve limb salvage.
- Early management and addressing associated injuries are key to preventing amputation.
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