[Clinical diagnosis and treatment of superior tibial fracture complicating with crotch injury of distal popliteal artery].
OBJECTIVE
To investigate the clinical effects of treatment for superior tibial fracture complicating with crotch injury of distal popliteal artery by an alternative micro-surgical operation.


METHODS
During Feb. 2002 to Oct. 2007, there were 19 patients with superior tibial fracture complicating with crotch injury of distal popliteal artery included 15 males and 4 females aged from 21 to 48 years (means 35 years). There were 6 cases complicating with fracture of tibial plateau, 3 cases complicating with nerve injury. The tibial fracture were fixed with external fixator and the anterior tibial artery and vein and posterior tibial artery and vein were treated by transplantable great saphenous vein (Y-shape) combined with windowing for interosseous membrane by the posterior and anterolateral incision. Evaluations of clinical effect were performed according to Rasmussen functional score system.


RESULTS
All patients survived after operation. All fracture achieved bony union, the union time was from 3 to 14 months (means 5.5 months). All patients were followed-up for from 8 to 23 months (means 13 months). The mean Rasmussen functional score was (27.0 + 2.9). The results were excellent in 11 cases, good in 7, and fair in 1.


CONCLUSIONS
The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. Simultaneous reconstruction of both posterior tibial artery and anterior tibial artery associated with vein can reduce the rate of disability and recover function of limb.
Wang
Bu-xing
BX
Wendeng Orthopaedics and Traumatic Hospital, Wendeng 264400, Shandong, China. wbx9778@yahoo.com.cn
Wang
Qing-jiao
QJ
Zhu
Hui-fang
HF
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006119:Groin / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries* / Q000601:surgery; D019651:Plastic Surgery Procedures; D013978:Tibial Fractures / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult