Reed M K, Lowry P A, Myers S I
David Grant U.S. Air Force Medical Center, Travis Air Force Base, California.
Am J Surg. 1990 Sep;160(3):287-90. doi: 10.1016/s0002-9610(06)80025-5.
Limb salvage after popliteal artery trauma in children demands the best in judgement and technique from the vascular or trauma surgeon. From September 1, 1985, through August 30, 1988, seven patients under age 18 were referred to our Center with popliteal arterial trauma. Four had blunt injuries and three had penetrating injuries. Associated injuries included three fractures, four severe soft tissue wounds, and one nerve injury. All patients underwent angiography, four preoperative and three intraoperative. Treatment included two primary repairs, four vein graft bypasses, and one fasciotomy and intraoperative angiography. Anastomoses were spatulated and sutured in an interrupted fashion. There were no deaths, amputations, or reoperations. At 10 to 42 months after repair, all patients have normal Doppler pressures and/or distal pulses. This study is the largest reported series of these challenging injuries. Contrasting with previous reports, it suggests that with prompt, aggressive treatment, a successful outcome may be anticipated.
儿童腘动脉损伤后的保肢手术需要血管外科医生或创伤外科医生具备最佳的判断力和技术。从1985年9月1日至1988年8月30日，7名18岁以下的儿童因腘动脉损伤被转诊至我们中心。4例为钝性损伤，3例为穿透性损伤。相关损伤包括3处骨折、4处严重软组织伤口和1处神经损伤。所有患者均接受了血管造影，4例为术前造影，3例为术中造影。治疗方法包括2例一期修复、4例静脉移植搭桥术、1例筋膜切开术和术中血管造影。吻合口呈鱼嘴状并间断缝合。无死亡、截肢或再次手术情况。修复后10至42个月，所有患者的多普勒压力和/或远端脉搏均正常。本研究是报道的此类具有挑战性损伤的最大系列病例。与以往报告不同的是，本研究表明，通过及时、积极的治疗，可以预期获得成功的结果。
