Winter G, Sperling M, Steinhäusser M
Dtsch Med Wochenschr. 1978 May 5;103(18):786-9. doi: 10.1055/s-0028-1104511.
Eighteen arterial reconstructions after trauma in the region of the knee joint were performed between 1970 and 1976. In seven cases there had been fracture of the distal femur, in five of the head of the tibia, in three dislocation of the knee joint or severe contusion of the popliteal artery. In 12 cases referral had been eight hours or later after injury. The concomitant vessel injury was not recognised in six. Vascular reconstruction by direct suture with a venous patch was performed in eight, interposition of a venous autograft in five, and saphenous vein bypass in four. Results depended upon length of ischaemia time and the level of the vascular injuries. Complete restitution to normal was achieved in only two cases, while in the remaining 12 there were defects of motor and sensory function as seen in the post-ischaemia syndrome. In four cases above-knee amputation was necessary despite successful reconstruction of the artery because there was irreversible ischaemic damage with tissue necrosis. To improve these results careful examination of blood vessels and, in questionable cases, angiography is recommended for every trauma victim.
1970年至1976年间，对膝关节区域创伤后的18例动脉进行了重建。其中7例为股骨远端骨折，5例为胫骨头部骨折，3例为膝关节脱位或腘动脉严重挫伤。12例患者在受伤8小时或更晚才转诊。6例未识别出合并的血管损伤。8例行直接缝合加静脉补片的血管重建，5例行自体静脉移植，4例行大隐静脉旁路移植。结果取决于缺血时间长短和血管损伤程度。仅2例完全恢复正常，其余12例出现了缺血后综合征所见的运动和感觉功能缺陷。4例尽管动脉重建成功，但因存在不可逆的缺血性损伤伴组织坏死，仍需行膝上截肢术。为改善这些结果，建议对每位创伤患者仔细检查血管，对可疑病例进行血管造影。
