Civilian popliteal artery trauma.

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Orthopedic Surgery

Background:

• Popliteal artery injuries are severe vascular emergencies.
• These injuries frequently occur in conjunction with fractures and dislocations.
• Blunt trauma is a more common cause than penetrating trauma.

Purpose of the Study:

• To review an 18-year experience with civilian popliteal artery injuries.
• To evaluate surgical reconstruction outcomes and complication rates.
• To analyze the impact of associated skeletal injuries.

Main Methods:

• Retrospective review of 36 civilian popliteal artery injury cases over 18 years.
• Analysis of injury mechanisms (penetrating vs. blunt), associated injuries, and treatment modalities.
• Surgical reconstruction techniques included autogenous saphenous vein grafts, vein patches, primary anastomosis, and PTFE prosthesis.
• Postoperative assessment included angiography, patency rates, and functional outcomes.

Main Results:

• Low amputation rate of 3.6% and no operative or hospital deaths.
• Blunt trauma (69.4%) was more frequent than penetrating trauma (30.6%).
• Popliteal artery injury was associated with fracture/dislocation in 55.5% of cases.
• Autogenous saphenous vein grafts were the most common reconstruction method (80.5%).
• High patency rate (89.2%) for reconstructions at a mean follow-up of 76 months.
• Complete success achieved in 46.4%, with complications including nerve deficits (25.0%) and claudication (10.7%).

Conclusions:

• Surgical reconstruction of civilian popliteal artery injuries, particularly with vein grafts, yields favorable outcomes.
• Early stabilization of associated fractures/dislocations followed by vascular repair is crucial.
• Despite complications, limb salvage and functional recovery are achievable.
• Anticoagulant therapy is frequently used postoperatively for at least one year.