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Popliteal artery war injuries

L Davidović1, S Lotina, D Kostić

  • 1The Institute for Cardiovascular Diseases, Medical Centre of Serbia, Belgrade, Yugoslavia.

Cardiovascular Surgery (London, England)
|February 1, 1997
PubMed
Summary

Surgically treated popliteal arterial injuries from war resulted in a 72% limb salvage rate. Complicated injuries, like those with fractures or from explosions, significantly increased amputation risk, favoring in situ or lateral subcutaneous reconstructions.

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Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Military Medicine

Background:

  • Popliteal arterial injuries are severe consequences of wartime trauma.
  • Early and effective surgical intervention is critical for limb salvage.

Purpose of the Study:

  • To report early postoperative results of surgically treated popliteal arterial injuries sustained during the Yugoslav civil war.
  • To identify factors influencing amputation rates and evaluate reconstruction techniques.

Main Methods:

  • Retrospective analysis of 44 patients with surgically treated popliteal arterial injuries.
  • Detailed review of injury mechanisms (gunshot vs. explosive), associated injuries (bone fractures), and surgical reconstruction methods (vein grafts, bypasses).
  • Assessment of early graft patency and limb salvage rates, with statistical analysis of factors affecting outcomes.

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Main Results:

  • A 72% limb salvage rate was achieved, with a 28% major amputation rate.
  • Explosive wounds, concomitant bone fractures, secondary reconstructions, and graft infections significantly increased amputation risk (P < 0.01).
  • In situ or lateral subcutaneous reconstructions were associated with lower amputation rates compared to anatomic reconstructions.

Conclusions:

  • Popliteal artery injuries in wartime present significant challenges to limb salvage.
  • Factors such as injury mechanism, associated fractures, and the need for secondary procedures negatively impact outcomes.
  • In situ or lateral subcutaneous reconstruction techniques are recommended for complex popliteal artery injuries, especially when delayed or infected.