Martinez D, Sweatman K, Thompson E C
Department of Cardiovascular Surgery, Wake Forest University Medical Center, Winston-Salem, North Carolina, USA.
Am Surg. 2001 Feb;67(2):165-7.
Since the Vietnam War experience we have known that there is a high association between knee dislocations and popliteal artery injuries. In an effort to improve the quality of care we asked whether every patient with a knee dislocation needs an arteriogram. This is a retrospective chart review of all injured patients who presented to Louisiana State University Health Science Center with knee dislocations between January 1, 1993 and March 31, 1998. Twenty-one patients met the study criteria. There were no deaths in this series. Twelve patients presented with normal palpable pulses. Nine of these 12 patients underwent an arteriogram. There was only one abnormal arteriogram (intimal defect) in this group. None of the patients who presented with normal pulses were operated on. There were no in-hospital complications from this nonoperative management. In the group of patients with either diminished pulses or no pulses arteriograms were performed on all patients. Fifty-five per cent of these arteriograms were abnormal, and one-third of these patients (two) were taken to the operating room for repair. In the group of patients who present with knee dislocations and normal peripheral vascular examination arteriograms are not helpful.
自越南战争以来我们就知道，膝关节脱位与腘动脉损伤之间存在高度关联。为了提高护理质量，我们探讨了是否每个膝关节脱位患者都需要进行动脉造影。这是一项对1993年1月1日至1998年3月31日期间到路易斯安那州立大学健康科学中心就诊的所有膝关节脱位受伤患者的回顾性病历审查。21名患者符合研究标准。该系列中无死亡病例。12名患者就诊时可触及的脉搏正常。这12名患者中有9名接受了动脉造影。该组中只有1例动脉造影异常（内膜缺损）。脉搏正常的患者均未接受手术。这种非手术治疗未出现院内并发症。在脉搏减弱或无脉搏的患者组中，所有患者均进行了动脉造影。这些动脉造影中有55%异常，其中三分之一的患者（2名）被送往手术室进行修复。对于膝关节脱位且外周血管检查正常的患者组，动脉造影并无帮助。
