Civilian popliteal artery trauma.

An 18 year experience involved 36 civilian popliteal artery injuries is described. There were no operative or hospital deaths and the amputation rate was 3.6%. Penetrating traumas accounted for 30.6% and blunt traumas for 69.4%. In 20 patients (55.5%) the popliteal artery injury was associated with fracture and/or dislocation of the long bones and/or the knee joint. The average ischaemic time was 7.3 hours and postoperative angiography was performed in 25 patients (69.4%). Surgical reconstruction of the popliteal artery was accomplished by interposition or bypass of autogenous saphenous vein graft in 29 (80.5%), by saphenous vein patch in 5 (13.9%) and by primary end-to-end anastomosis in 1 (2.8%) and by PTFE prosthesis in 1 patient (2.8%). In all cases with bone fracture and/or dislocation bone stabilization was followed by the vascular procedure. The average time of follow-up was 76 months, 28 patients could be evaluated in the postoperative study: in 25 (89.2%) the reconstruction was patent, in 3 (10.8%) occluded. In 13 patients (46.4%) there was a complete success, 7 had a nerve deficit (25.0%), 3 had a claudication (10.7%), in one patient an amputation was necessary (3.6%) and 4 (14.3%) suffered from miscellaneous skeletal problems. Of the 36 patients originally operated, 29 (80.5%) received anticoagulant therapy for at least one year.