Abstract
PURPOSE : This study had been performed to evaluate the factors affecting either saving the
limb or amputation after popliteal artery injury associated with fractures or dislocation around
the knee.
MATERIALS and METHODS : Twelve patients of popliteal artery injury were included. Authors
had analysed nine probable factors as follows - age, sex, injury mechanisms, injury types,
interval between injury and time to arrive at the hospital, interval between injury and time of
operation, surgical methods for revascularization, severity of extremity injuries and fasciotomy,
for discrimination between the limb-saving group and the amputation.
RESULTS: Ten patients were arrived at the hospital within 48 hours after the injury. Each
patient was managed by end-to-end anastomosis in 6 cases and autogenous vein graft in 4 cases
and among them, 2 cases needed additional amputation for vascular compromise. All limbs
could be saved in which cases operate within 6 hours after the injury. However, the limb was lost
in one of 6 cases(16.7%) between 6 and 20 hours, in one of two cases(50%) over 20 hours. One
of 7 cases(14.3%) with the Mangled Extremity Severity Score(MESS) of 2 to 4 points, two of 4
cases(50%) with MESS of 5 to 6 points and one(100%) with MESS of 7 points were amputated.
All 4 patients associated with fasciotomy could save their limbs, however, two of 6 patients not
associated with fasciotomy lost.
SUMMARY : Authors thought the most reliable predictors for saving the limbs after the
popliteal artery injury might include the MESS and fasciotomy, however, ischemic time more
than 6 hours might not be an absolute indication for amputation.