Arterial injuries in orthopaedics: the posteromedial approach for vascular control about the knee.
Combined orthopaedic and vascular injuries are becoming more common owing to an increasing incidence of high-energy trauma and gunshot wounds. We present our experience using the posteromedial approach in treating eight orthopaedic patients with popliteal arterial injuries. All patients underwent popliteal exploration by a vascular surgeon through a posteromedial approach (releasing the pes anserinus and the medial gastrocnemius). The arterial injuries were reconstructed in five patients using a reverse saphenous vein graft and directly repaired in three patients. Two patients had delayed healing of their incisions as a result of the original injury. There were no neural injuries. The posteromedial approach is extensile and utilitarian, and it represents the exposure of choice for arterial injuries about the knee.
Muscat
J O
JO
Department of Orthopaedics, University of Texas Health Science Center at San Antonio 78284-7774, USA.
Rogers
W
W
Cruz
A B
AB
Schenck
R C
RC
D000293:Adolescent; D000328:Adult; D006801:Humans; D007718:Knee Injuries / Q000150:complications*; D007719:Knee Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular; D012501:Saphenous Vein / Q000637:transplantation; D014656:Vascular Surgical Procedures / Q000379:methods; D014948:Wounds, Gunshot / Q000601:surgery