title: Civilian popliteal artery injuries.
abstract: BACKGROUND
  Civilian popliteal artery injuries are associated with significant amputation rates.
  
  
  OBJECTIVE
  The aim of this study was to identify factors associated with limb loss in patients with popliteal artery injuries.
  
  
  METHODS
  We performed a retrospective chart review of prospectively collected data on patients with popliteal artery injuries presenting to the Trauma Centre at Groote Schuur Hospital, Cape Town, from 1 January 1999 to 31 December 2008. Demographic data, mechanism of injury, haemodynamic status, limb viability, special investigations, associated injuries, ischaemic time, surgical treatment and amputation rates were analysed.
  
  
  RESULTS
  One hundred and thirty-six patients with popliteal artery injuries were identified. Penetrating and blunt trauma accounted for 81 (59.6%) and 55 (40.4%) injuries, respectively. Associated injuries included fractures in 66 patients (48.6%), knee dislocations in 29 (21.3%) and popliteal vein injuries in 59 (43.4%). Fifty-seven patients (41.9%) presented with a compartment syndrome. Arterial injuries were treated with reversed vein grafting in 68 patients, primary anastomosis in 33, prosthetic graft insertion in 11, and primary amputation in 7. Thirty-two patients underwent delayed amputation, giving an overall amputation rate of 37.5%. A delay of more than 7 hours of ischaemic time between injury and definitive repair (p=0.0236) and the presence of a compartment syndrome (p=0.003) were significantly associated with an increased amputation rate.
  
  
  CONCLUSIONS
  The most significant factors associated with the high amputation rate of 37.5% were an ischaemic time longer than 7 hours, and the presence of a compartment syndrome.
authors.affiliation: Trauma Centre, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Mohammed Asif
authors.initials: MA
authors.lastname: Banderker
authors.forename: Pradeep Harkison
authors.initials: PH
authors.lastname: Navsaria
authors.forename: Sorin
authors.initials: S
authors.lastname: Edu
authors.forename: Wanda
authors.initials: W
authors.lastname: Bekker
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Nicol
authors.forename: Nadraj
authors.initials: N
authors.lastname: Naidoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation; D003161:Compartment Syndromes / Q000209:etiology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries* / Q000601:surgery*; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*; D014950:Wounds, Penetrating / Q000150:complications / Q000601:surgery*; D055815:Young Adult