DOI: 10.36347/SASJS.2019.v05i10.004

Pages: 391-395

Introduction: Popliteal artery injury is associated with higher amputation rates than any other extremity vascular injury. We describe 3 cases of traumatic popliteal artery injuries in our unit over the past month. Results: Two of these patients were managed with an interposition graft and one patient was treated conservatively. All patients regained distal pulses successfully. One patient developed reperfusion injury. Discussion: The popliteal artery, by virtue of its ligamentous fixation and anatomic relationships to the femur, tibial plateau, and knee joint apparatus, is uniquely susceptible to injury with blunt extremity trauma.1 Physical examination is imperative in recognising vascular injury. The Rutherford classification for acute limb ischaemia serves as a crucial guide for deciding between conservative, revascularisation and amputation. Amputation rates for popliteal artery injuries vary from 19.6% reported by Keeley et al., 14.5% by Mullenix et al and 16.2% by Hafez et al.3 Compartment syndrome after vascular repair is associated with higher rates of amputation. Though prophylactic fasciotomy is still controversial. Lim et al and Frykberg et al both advocate early fasciotomy and not waiting until signs of compartment syndrome arise.2 We performed fasciotomy for the first and second patients in view of the delay to surgery (>6 hours) which was mainly due to transferring logistics.