Treiman G S, Yellin A E, Weaver F A, Wang S, Ghalambor N, Barlow W, Snyder B, Pentecost M J
Department of Surgery, Los Angeles County-University of Southern California Medical Center 90033.
Arch Surg. 1992 Sep;127(9):1056-62; discussion 1062-3. doi: 10.1001/archsurg.1992.01420090060009.
One hundred fifteen patients with a unilateral knee dislocation underwent arteriography to examine the popliteal artery. The incidence of popliteal artery injury was 23% (27 patients). Clinically, 29 (25%) of the 115 patients had an abnormal ipsilateral pedal pulse and 23 (79%) of these 29 patients had an arteriographically identified popliteal artery injury. Twenty-two arteries were surgically repaired and one was treated without surgery. Eight-six patients had normal pulses; the arteriogram showed no abnormalities in 77, demonstrated spasm in five, and revealed an intimal flap in four. All 86 patients were treated without surgery and had no delayed vascular complications. This demonstrates that the vascular examination is an accurate predictor of major popliteal artery injury following knee dislocation. Patients with an abnormal pedal pulse warrant arteriography due to a high incidence (79%) of popliteal artery injury. Patients with normal pulses may be monitored by clinical examination only. Popliteal artery injuries in this group are minor and rarely require intervention.
115例单侧膝关节脱位患者接受了动脉造影以检查腘动脉。腘动脉损伤的发生率为23%（27例患者）。临床上，115例患者中有29例（25%）同侧足部脉搏异常，这29例患者中有23例（79%）经动脉造影确定存在腘动脉损伤。22条动脉接受了手术修复，1条未进行手术治疗。86例患者脉搏正常；动脉造影显示77例无异常，5例显示痉挛，4例显示内膜瓣。所有86例患者均未进行手术治疗，也没有出现延迟性血管并发症。这表明血管检查是膝关节脱位后腘动脉主要损伤的准确预测指标。足部脉搏异常的患者因腘动脉损伤发生率高（79%）而需要进行动脉造影。脉搏正常的患者仅通过临床检查进行监测。该组中的腘动脉损伤较轻，很少需要干预。
