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


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


RESULTS
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.


CONCLUSIONS
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.
Departement Chirurgie, Universitätsspital Zürich.
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Platz
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Lazzaro
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Simmen
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Trentz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D007717:Knee / Q000098:blood supply*; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013536:Suture Techniques; D014680:Veins / Q000293:injuries / Q000601:surgery
Diagnostik und Therapie von Gefässverletzungen bei posterioren Knieluxationen.