[Diagnosis and therapy of vascular injuries in posterior knee dislocation]

We demonstrate the management and treatment of dislocation of the knee associated with vascular injury. The goal of the treatment is to avoid complications due to ischemia. The injured vessel can be repaired either by direct suture or by interposition of a saphenous vein graft. Capsule and ligaments should be reconstructed secondarily.

The charts of ten patients treated in the Division of Traumatology of the University of Zurich between 1979 and 1996 have been retrospectively checked.

In eight of ten patients the injured vessel has been reconstructed with a saphenous vein graft, in one patient the artery has been repaired by direct suture. In one patient a flap of the intima has been refixed by endarterectomy. In five patients the knee has been stabilised with a transfixation (external fixation). In two patients the ligaments and the capsule were reconstructed at the time of vascular repair, in seven patients the reconstruction has been performed secondary.

In case of a dislocation of the knee the examination of the vessels is mandatory. In case of a critical perfusion the "on table"--angiography is the procedure of choice. As an alternative method duplex sonography has been established. The vascular reconstruction is performed by saphenous vein graft interposition. We recommend to reconstruct ligamentous and capsular structures secondary.