Cvetković Slobodan, Jakovljević Nenad, Simić Dusica, Sladojević Milos, Djurasić Ljubomir, Davidović Lazar
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia.
Vojnosanit Pregl. 2014 Jan;71(1):87-90. doi: 10.2298/vsp1401087c.
Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function.
We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee.
Combined orthopedic and vascular injuries are very rare in children. They require combined treatment.
儿童膝关节后脱位合并腘动脉损伤极为罕见。快速诊断和治疗对于挽救肢体及恢复功能至关重要。
我们报告了一名14岁男孩，在摩托车事故中右膝关节发生创伤性移位且腘动脉挫伤。通过多普勒和双功超声检查以及数字减影股动脉造影确诊。采用腘动脉后入路进行了紧急手术。手术探查时，发现后交叉韧带断裂合并腘动脉血栓形成。切除受损的腘动脉，并用自体大隐静脉移植替代。手术的最后阶段是对后交叉韧带进行经骨股骨固定。术后3年随访显示动脉灌注良好，膝关节功能非常好，与对侧膝关节相比差异极小。
儿童骨科和血管联合损伤非常罕见。它们需要联合治疗。
