[Early diagnosis and treatment for trauma around the knee with popliteal vascular injury].
OBJECTIVE
To investigate the early diagnosis and treatment for trauma around the knee with popliteal vascular injury.


METHODS
A retrospective analysis was employed to analyze the clinical data from 15 patients (9 males and 6 females were with a mean age of 39.2 years old,ranging from 26 to 62 years old) with fracture or dislocation around the knee with popliteal vascular injury from January 2007 to January 2013. Combined with clinical symptoms and signs, oxygen saturation monitors, color ultrasound, DSA angiography and interventional surgery were used to determine the vascular injury. The knee fracture and dislocation were fixed with hybrid external fixation and plate-screw fixation, respectively. Then, the blood circulation was reconstructed by thrombectomy, repair and autologous vein graft for individual injured vascular. The average total operation time, average hospitalization days, predictive salvage index (PSI), average blood transfusion amount, average medical expenses and infection cases were recorded to determine the effect of early diagnosis and treatment.


RESULTS
There was one patient with death, 8 patients with amputation, and 6 patients with successful repair surgery for popliteal artery, anterior tibial and posterior tibial arteries. These six patients with surviving limbs were followed up for an average of 28.3 months (ranged, 12 to 60 months). Among the 6 successful patients, the joint function of 4 patients was good and excellent.


CONCLUSIONS
The trauma around the knee with popliteal vascular injury is characterized by complex and serious injury, easy misdiagnosis and loss diagnosis, poor prognosis and high risk of amputation. The early diagnosis of trauma around the knee with popliteal vascular injury should depend on the mechanism of trauma, local anatomical characteristics of injury site, clinical presentations and appropriate auxiliary examinations. The appropriate indications for limb salvage and amputation should be used to achieve more effective clinical results.
Yun-Qin
YQ
Xu
Qiang
Q
Li
Tu-Gang
TG
Shen
Pei-Hua
PH
Su
Gang
G
Wang
You-Rong
YR
Yao
Pan
P
Deng
Zheng-Li
ZL
Luo
Qiang-Qiang
QQ
Wei
Cheng-Bin
CB
Qiu
Chen Wei
Hai-Qiang
HQ
Shen
D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies