Kaufman S L, Martin L G
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
Radiology. 1992 Jul;184(1):153-5. doi: 10.1148/radiology.184.1.1609074.
To determine the frequency and type of arterial injuries associated with complete dislocation of the knee and to correlate the findings at physical examination with those at arteriography, a computerized search for patients with a diagnosis of dislocation of the knee at discharge from an urban trauma hospital was performed. Nineteen patients with complete dislocation of the knee were found. Arterial injuries were seen in six patients (32%). Four of the 19 patients had no pedal pulse at physical examination. In three of these four patients, occlusion of the popliteal artery was seen on arteriograms. The fourth patient had occlusion of an anomalous anterior tibial artery and a compartmental syndrome. Two of the 15 other patients with pedal pulses (13%) had nonoccluding intimal defects of the popliteal artery; these two patients did well without surgery. It is concluded that abnormal peripheral pulses associated with complete knee dislocation are highly predictive of major arterial injury. If peripheral pulses are normal, a low but definite frequency of arterial damage exists.
为了确定与膝关节完全脱位相关的动脉损伤的频率和类型,并将体格检查结果与动脉造影结果进行对比,我们对一家城市创伤医院出院诊断为膝关节脱位的患者进行了计算机检索。共发现19例膝关节完全脱位患者。6例患者(32%)出现动脉损伤。19例患者中有4例在体格检查时无足背动脉搏动。这4例患者中的3例在动脉造影片上可见腘动脉闭塞。第4例患者为异常胫前动脉闭塞并伴有骨筋膜室综合征。其他15例有足背动脉搏动的患者中有2例(13%)出现腘动脉非闭塞性内膜缺损;这2例患者未经手术治疗,恢复良好。结论是,与膝关节完全脱位相关的外周脉搏异常高度预示着主要动脉损伤。如果外周脉搏正常,仍存在较低但确定的动脉损伤频率。