Journal article
Patient Selection for Nonoperative Management of Popliteal Artery Injuries: A Case Report
Vascular surgery, Vol.31(4), pp.509-514
07/01/1997
DOI: 10.1177/153857449703100416
Abstract
A twenty-six-year-old man was involved in a farming accident, whereby a corn head from a combine fell on his legs. He was transported by air care to the emergency room approx imately seventy-five minutes after the accident. Upon examination the patient was alert with a pulse of 100/minute, blood pressure 116/80 mmHg, and respiratory rate 20/minute. There was an anterior dislocation of the left knee with a wound in the popliteal fossa measuring 8 x 6 cm. There was a normal palpable left femoral pulse, but distal pulses were detectable only by Doppler. There was no evidence of an expanding hematoma or bruit. He had a left-sided foot drop with a cold, pale foot with diminished sensation. Roentgenograms of the lower extremities revealed an anterior dislocation of the left knee without any associated fracture. The patient was taken urgently to the operating room, and under general anesthesia a reduction of the anterior dislocation of the left knee, with debridement and irrigation of the wound, was done followed by stabi lization of the knee with an external fixator. The patient had palpable left posterior tibial and dorsal pedis artery pulses following the reduction. Intraoperative arteriography under fluoroscopy was then performed via the left femoral route by the Seldinger technique. This revealed a 50% 5-cm-long smooth stenosis of the left popliteal artery with normal distal runoff. It was decided to manage the patient's popliteal artery injury nonoperatively with anticoagulation and in-hospital serial observations. Duplex examination of the left popliteal artery confirmed the arteriographic findings. The patient was given intravenous heparin therapy for three days followed by warfarin for three months and is currently taking aspirin (325 mg/day). A follow-up duplex examination at one week and at one, six, and fifteen months following the injury revealed a normal healed popliteal artery.
Traumatic knee dislocations have a well-known association with popliteal artery injuries. Because of a high amputation rate associated with missed or delayed diagnosis of popliteal artery injuries, early diagnosis and repair of such injuries is the standard of care.
The authors describe the nonoperative management of this injury and review the literature on this subject.
Details
- Title: Subtitle
- Patient Selection for Nonoperative Management of Popliteal Artery Injuries: A Case Report
- Creators
- Chittur R. Mohan - University of Iowa Hospitals and ClinicsWilliam J. Sharp - University of IowaJamal J. Hoballah - University of IowaTheodore Boeve - University of Iowa Hospitals and ClinicsTimothy F. Kresowik - University of IowaJohn D. Corson - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Vascular surgery, Vol.31(4), pp.509-514
- DOI
- 10.1177/153857449703100416
- ISSN
- 0042-2835
- eISSN
- 1938-9116
- Language
- English
- Date published
- 07/01/1997
- Academic Unit
- Radiology; Surgery
- Record Identifier
- 9984383916402771
Metrics
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