[Popliteal vascular injuries. Prognostic classification]

Despite recent advances in the treatment of vascular injuries, the prognosis of injuries to the popliteal vessels is still poor with an incidence of 10-40 p. 100 of amputations recorded in the literature. Mortality rate is 4 p. 100. The authors have seen 13 cases and have studied seven factors influencing the prognosis - the duration of ischaemia, the general condition of the patient, the type of lesion, the state of the veins, the severity of the ischaemia, the level of the lesion and associated soft tissue injury and wounds. Each of the parameters has been assessed with a grade proportional to its severity. The summation of the grades leads to a division into three degrees of increasing severity and allows an early prognosis to be made. In the most severe degree of the lesion, amputation should be performed immediately. Twenty-one attempts at conservative surgery resulted in success in only four cases, with 17 amputations and four deaths among these.