Successful repair of pediatric popliteal artery trauma

Limb salvage after popliteal artery trauma in children demands the best in judgement and technique from the vascular or trauma surgeon. From September 1, 1985, through August 30, 1988, seven patients under age 18 were referred to our Center with popliteal arterial trauma. Four had blunt injuries and three had penetrating injuries. Associated injuries included three fractures, four severe soft tissue wounds, and one nerve injury. All patients underwent angiography, four preoperative and three intraoperative. Treatment included two primary repairs, four vein graft bypasses, and one fasciotomy and intraoperative angiography. Anastomoses were spatulated and sutured in an interrupted fashion. There were no deaths, amputations, or reoperations. At 10 to 42 months after repair, all patients have normal Doppler pressures and/or distal pulses. This study is the largest reported series of these challenging injuries. Contrasting with previous reports, it suggests that with prompt, aggressive treatment, a successful outcome may be anticipated.