McNeil J W, McGee G S
Department of Surgery, University of South Alabama Medical School, Mobile.
South Med J. 1994 Sep;87(9):958-60. doi: 10.1097/00007611-199409000-00022.
We discuss the case of a patient with knee dislocation and popliteal artery injury. A high index of suspicion for vascular injury must be maintained in cases of blunt knee injury because more than one third of patients with knee dislocation will have an associated popliteal artery injury. Patients with a grossly unstable knee after blunt trauma often have had a knee dislocation; such patients should receive aggressive evaluation for popliteal artery injury. Arteriography should be done for all trauma patients with a grossly unstable knee joint or knee dislocation and palpable pedal pulses. For patients with severe limb ischemia, arteriograms may be done in the operating room to expedite revascularization. Without rapid recognition and revascularization, blunt injury to the popliteal artery results in a rate of limb loss of more than 30%.
我们讨论了一例膝关节脱位合并腘动脉损伤的患者。对于钝性膝关节损伤病例,必须保持对血管损伤的高度怀疑指数,因为超过三分之一的膝关节脱位患者会伴有腘动脉损伤。钝性创伤后膝关节严重不稳定的患者通常发生了膝关节脱位;此类患者应接受积极的腘动脉损伤评估。对于所有膝关节严重不稳定或膝关节脱位且可触及足背脉搏的创伤患者,均应进行动脉造影。对于严重肢体缺血的患者,可在手术室进行动脉造影以加快血管重建。如果不能迅速识别并进行血管重建,腘动脉钝性损伤会导致超过30%的肢体丧失率。