Outcome of popliteal arterial injuries presenting to the Teaching Hospital, Anuradhapura

Introduction

Popliteal artery (PA) injury is an emergency that has a high limb threat potential.

Methodology
This is a retrospective study of those with documented PA injuries in bed head tickets among those presenting with arterial injuries to the Teaching Hospital, Anuradhapura (THA) from January 2017 to June 2019. Demography, anatomical details of injury, concomitant injuries, type of surgical intervention and perioperative outcomes were assessed.

Results
Twenty case records were studied. Eighteen (90%) were males, with a mean age of 38.7 years (18-69). Eight (40%) were following motorcycle accidents and 7 (35%) were trap gun injuries. Median ischemic time was 9.5 hours (3-29). Seventeen (85%) had associated fracture or dislocation (p0.003). Four (20%) had associated venous injury. Seven arteries (35%) were contused, 6 (30%) were lacerated. Eleven (55%) underwent reversed saphenous vein graft repair, end to end anastomosis was done in 1 (5%) and ligation was done in 2 (10%). None of the patients underwent fasciotomy at the hospital where they were admitted first. Nine of fourteen patients (64.3%) had all compartments viable on fasciotomy. Two (10%) patients following trap gun injury who also had associated venous injury underwent amputation. Concomitant venous injury had a significant association with amputation rate (p 0.0316)

Conclusion
Motorcycle accidents and trap guns were the leading cause of PA injury. PA injury was significantly associated with fractures around the knee joint. Concomitant popliteal venous injury, which is common after trap gun injury, had significant association with poor outcome.