Scola E, Zwipp H
Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
Unfallchirurg. 1991 May;94(5):254-6.
Between 1973 and 1988 50 patients with injuries of the popliteal artery were treated at the Medical School of Hannover University. While 26 patients with dislocations of the knee joint had mild soft tissue injuries, most of the 24 patients with periarticular fractures of the tibia and/or femur showed excessive soft tissue damage. In both groups 11 patients who were admitted with prolonged ischemia had to undergo amputations. Primary amputations were performed according to the recommendations of. The mean duration of ischemia was 5.5 h (range 2.2-9 h) in patients with knee dislocations (n = 21); fasciotomy was performed in 14 patients (67%). In patients with popliteal artery injuries combined with fractures (n = 18) the average duration of ischemia was 6.5 h (3-13.5 h); in 16 cases in this group (89%) fasciotomy had to be performed. Fasciotomy was always necessary in patients with combined injuries of the popliteal vein and artery. Moreover, all patients with ischemia of more than 6 h duration required fasciotomy. It can be concluded that fasciotomy will probably be necessary in patients with injuries of the popliteal artery and (a) severe soft tissue damage of the thigh and/or lower leg with compartment pressure of more than 30 mmHg; (b) ischemia of more than 6 h duration; (c) combined injuries of the popliteal vein and artery; (d) reconstruction of severely injured extremities. In general, fasciotomy should always be considered after reconstruction of the popliteal artery.
1973年至1988年间，汉诺威大学医学院共治疗了50例腘动脉损伤患者。26例膝关节脱位患者伴有轻度软组织损伤，而24例胫骨和/或股骨关节周围骨折患者中，多数伴有严重的软组织损伤。两组中，11例因缺血时间延长入院的患者均不得不接受截肢手术。一期截肢手术是根据……的建议进行的。膝关节脱位患者（n = 21）的平均缺血时间为5.5小时（范围2.2 - 9小时）；14例患者（67%）进行了筋膜切开术。腘动脉损伤合并骨折的患者（n = 18）平均缺血时间为6.5小时（3 - 13.5小时）；该组16例患者（89%）不得不进行筋膜切开术。腘动静脉合并损伤的患者总是需要进行筋膜切开术。此外，所有缺血时间超过6小时的患者都需要进行筋膜切开术。可以得出结论，对于腘动脉损伤患者，在出现以下情况时可能需要进行筋膜切开术：（a）大腿和/或小腿严重软组织损伤且筋膜间室压力超过30 mmHg；（b）缺血时间超过6小时；（c）腘动静脉合并损伤；（d）严重损伤肢体的重建。一般来说，在腘动脉重建术后应始终考虑进行筋膜切开术。
