Hagan P F, Kaufman E E
Department of Surgery, University of Kansas School of Medicine, Wichita.
Clin Orthop Relat Res. 1990 Aug(257):159-61.
An 80-year-old white male was treated with a right total knee arthroplasty after three years of incapacitating knee pain that did not respond to conservative therapy. A pneumatic tourniquet was placed around the right proximal thigh prior to surgery. Before applying the dressing, assessment of the right foot revealed an adequate vascular status. On the first postoperative morning, the popliteal and pedal pulses were absent. An arteriogram identified complete occlusion of the distal superficial femoral artery and popliteal artery down to and including the trifurcation. After a right femoral artery embolectomy, the pulses returned and the patient suffered no residual deficit from the arterial occlusion. The patient had a prior history of prostatic carcinoma and was taking diethylstilbestrol; these factors, along with age-associated atherosclerotic disease and the tourniquet application, created a favorable environment for such a rare complication. Factors that may compromise vascularity when using the pneumatic tourniquet must be given due consideration.
一名80岁的白人男性，在经历了三年保守治疗无效的膝关节剧痛后，接受了右全膝关节置换术。手术前在右大腿近端放置了气压止血带。在包扎前，对右脚的评估显示血管状况良好。术后第一个早晨，腘动脉和足背动脉搏动消失。血管造影显示股浅动脉远端和腘动脉直至包括三叉分支处完全闭塞。在进行右股动脉取栓术后，脉搏恢复，患者未因动脉闭塞而留下任何后遗症。该患者既往有前列腺癌病史，正在服用己烯雌酚；这些因素，再加上与年龄相关的动脉粥样硬化疾病以及止血带的使用，为这种罕见的并发症创造了有利条件。使用气压止血带时可能损害血管的因素必须予以充分考虑。
