Revascularisation later than 24h after popliteal artery trauma: is it worthwhile?

Traumatic popliteal artery injury carries heavy morbidity. Ischaemic time is an important factor affecting limb survival. In developing countries most patients present late for repair and there are no distinct guidelines in deciding for revascularisation.

Patients with popliteal artery trauma who had presented at least 24h after injury were included in the study. Individuals with dead foot were excluded; participants underwent either amputation or revascularisation.

Among 30 patients entered in the study, 3 underwent amputation; of these, 2 had complete paralysis with partial sensory loss and 1 had complete sensory and motor loss. The rate of amputation was significantly higher among patients with motor deficit (p=0.008) but not among those with sensory deficit.

Revascularisation can be successful for patients who retain only one foot movement. We recommend revascularisation also for cases presenting late and with complete motor deficit below the knee, but without mottling.