Traumatic Popliteal and Infrapopliteal Arterial Injuries (Findings, Risk Factors and Treatment)

Yıl 2019, Cilt: 9 Sayı: 3, 122 - 128, 16.09.2019

İlker Akar

Öz

Objective: Limb loss following popliteal and infrapopliteal traumatic arterial injury has serious implications
on the patient’s life and functionality. The objective of this study is to review popliteal and infrapopliteal
arterial injuries treated in our clinic retrospectively.
Material and Methods: Between January 2012 and November 2018; 30 patients whom underwent
emergency surgery due to traumatic popliteal and infrapopliteal arterial injuries were analyzed.
Results: There were 27 (90%) males and 3 (10%) females. The mechanism of injuries was stab wounds in
43% of the cases (Group 1), gunshot wounds in 23,3% (Group 2) and blunt trauma in 33.3% (Group 3). The
mean MESS score was 3.90 in all cases, while it was 3.15±1.57 in Group 1, 4±0.82 in Group 2 and 4.8±1.32
in Group 3. All 3 cases of amputation were resulted from blunt trauma. A shorter length of hospitalization
was observed in patients with stab wounds compared to other injury types (p<0.001). Primary repair was
performed in 8 (20.5%), reverse saphenous vein interposition in 20 (51.2%), and ligation was in 11 cases
(28.2%). Compartment syndrome was developed in one patient in Group 1, 4 patients in Group 2 and 1 in
Group 3. Three patients were undergone in group 3.
Conclusion: It is important to provide accurate and rapid diagnosis by physical examination, appropriate
imaging methods and providing revascularization with appropriate methods and performing fasciotomy,
when necessary, in order to save the patient and related extremity

Anahtar Kelimeler

Trauma, Arterial injury, Popliteal artery, Infrapopliteal arteries

POPLİTEAL VE DİZALTI TRAVMATİK ARTERYEL YARALANMALAR ( BULGULAR, RİSK FAKTÖRLERİ VE TEDAVİ)

Öz

Amaç: Popliteal ve infrapopliteal travmatik arteriyel yaralanmayı takiben uzuv kaybı, hastanın yaşamı ve
işlevselliği üzerinde ciddi etkilere sahiptir. Bu çalışmanın amacı kliniğimizde retrospektif olarak tedavi edilen
popliteal ve infrapopliteal arter yaralanmalarının sonuçlarını incelemektir.
Gereç ve Yöntemler: Ocak 2012 ve Kasım 2018 arasında; Travmatik popliteal ve infrapopliteal arter yaralanmaları nedeniyle acil cerrahi geçiren 30 hasta analiz edildi.
Bulgular: Hastaların 27’si (% 90) erkek ve 3’ü (% 10) kadın idi. Yaralanma şekli olguların% 43'ünde bıçak
yaralanması (Grup 1),% 23,3'ünde (Grup 2) ateşli silah yaralanması ve % 33,3'ünde (Grup 3) künt travma
vardı. Ortalama MESS skoru tüm olgularda 3.90 iken Grup 1'de 3.15 ± 1.57, Grup 2'de 4 ± 0.82 ve Grup 3'te
4.8 ± 1.32 idi. Amputasyona giden 3 vaka da künt travma nedeniyle oluşmuştu. Delici-kesici alet yaralanması
olan hastalarda diğer yaralanma tiplerine göre daha kısa bir hastanede yatış süresi gözlendi (p <0.001). Uygulanan cerrahi teknikler; primer tamir 8 (% 20,5), ters safen ven interpozisyonu 20 (% 51,2), ligasyon 11 (%
28,2) idi. Grup 1'de bir hastada, Grup 2'de 4 hastada ve Grup 3'te 1 hastada kompartman sendromu gelişti.
Amputasyon uygulanan 3 hasta grup 3’de idi.
Sonuç: Fizik muayene ve uygun görüntüleme yöntemleriyle doğru ve hızlı tanı koymak, uygun yöntemlerle
revaskülarizasyon sağlamak, gerektiğinde fasiyotomi yapmak hastayı ve ekstremiteyi kurtarmak için önemlidir.

Anahtar Kelimeler

Travma, Arteryel yaralanma, Popliteal arter, Dizaltı arterler

Kaynakça

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