PMID- 29704953
OWN - NLM
STAT- MEDLINE
DCOM- 20181217
LR  - 20221207
IS  - 1879-0267 (Electronic)
IS  - 0020-1383 (Linking)
VI  - 49
IP  - 6
DP  - 2018 Jun
TI  - Risk factors associated with amputation in civilian popliteal artery trauma.
PG  - 1188-1192
LID - S0020-1383(18)30215-8 [pii]
LID - 10.1016/j.injury.2018.04.028 [doi]
AB  - Popliteal artery trauma is uncommon but is associated with a high risk of limb 
      loss depending on the scenario involving blunt or penetrating trauma as well as 
      the severity and extent of injury that has occurred. In our setting there is a 
      significant amount of gang and civilian warfare resulting in Vascular Trauma. 
      There were 32 patients over a decade who sustained traumatic injury to the 
      popliteal artery consisting of 30 males (94%) and 2 females with an age range 
      16-59 years with a mean of 32. There were 20 cases of penetrating trauma (63%) 
      and 12 cases of blunt trauma (37%). Of the penetrating trauma, 18 were due to 
      gunshot wounds (GSWs) (90%) and 2 stabs. The majority (7/12; 58%) of blunt trauma 
      was due to falls, and 42% (5/12) secondary to motor vehicular accidents (MVAs). 
      In terms of extent of injury, 21 of 32 patients (65%) sustained an isolated 
      popliteal artery injury, whilst 6 (19%) had injury to both the popliteal artery 
      and vein and another 5 (16%) had combined popliteal artery, vein and nerve 
      injuries. There were 14 cases with associated orthopaedic injuries: 7 posterior 
      knee dislocations, 1 fracture/dislocation of the knee, 2 femoral fractures, 2 
      tibial plateau fractures and 2 tibia/fibula fracture. Methods of repair included 
      14 reversed vein grafts, 16 polytetrafluoroethylene (PTFE) grafts and 2 primary. 
      The overall amputation rate was 28% (9 patients). Of the penetrating trauma 
      patients 25% required amputations composed of 5 GSWs, 33% of the blunt trauma 
      patients required amputations. It was noted that factors associated with (but not 
      statistically significant) poor outcomes included combined artery/vein injury, 
      artery/vein/nerve injury, concomitant fracture/dislocation and delayed transfer 
      to a Vascular Surgery Unit. The type of graft or repair did not affect outcome. 
      The incidence of popliteal artery trauma was calculated at 2.46 per 100,000 
      population per year.
CI  - Copyright (c) 2018 Elsevier Ltd. All rights reserved.
FAU - Ramdass, Michael J
AU  - Ramdass MJ
AD  - Department of Clinical Surgical Sciences, University of the West Indies, St. 
      Augustine, Trinidad, West Indies. Electronic address: 
      michael.ramdass@sta.uwi.edu.
FAU - Muddeen, Alyssa
AU  - Muddeen A
AD  - Department of Clinical Surgical Sciences, University of the West Indies, St. 
      Augustine, Trinidad, West Indies.
FAU - Harnarayan, Patrick
AU  - Harnarayan P
AD  - Department of Clinical Surgical Sciences, University of the West Indies, St. 
      Augustine, Trinidad, West Indies.
FAU - Spence, Richard
AU  - Spence R
AD  - Department of Clinical Surgical Sciences, University of the West Indies, St. 
      Augustine, Trinidad, West Indies.
FAU - Milne, David
AU  - Milne D
AD  - Department of Clinical Surgical Sciences, University of the West Indies, St. 
      Augustine, Trinidad, West Indies.
LA  - eng
PT  - Journal Article
DEP - 20180424
PL  - Netherlands
TA  - Injury
JT  - Injury
JID - 0226040
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Amputation, Surgical/*statistics & numerical data
MH  - Female
MH  - Hospitals, Teaching
MH  - Humans
MH  - Leg Injuries/complications/*physiopathology/surgery
MH  - Limb Salvage/*methods
MH  - Male
MH  - Middle Aged
MH  - Popliteal Artery/*injuries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Trinidad and Tobago/epidemiology
MH  - Vascular Surgical Procedures/methods
MH  - Vascular System Injuries/etiology/physiopathology/*surgery
MH  - Wounds, Nonpenetrating/complications/*physiopathology/surgery
MH  - Wounds, Penetrating/complications/*physiopathology/surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Civilian trauma
OT  - Popliteal artery trauma
EDAT- 2018/05/01 06:00
MHDA- 2018/12/18 06:00
CRDT- 2018/04/30 06:00
PHST- 2018/03/06 00:00 [received]
PHST- 2018/03/31 00:00 [revised]
PHST- 2018/04/23 00:00 [accepted]
PHST- 2018/05/01 06:00 [pubmed]
PHST- 2018/12/18 06:00 [medline]
PHST- 2018/04/30 06:00 [entrez]
AID - S0020-1383(18)30215-8 [pii]
AID - 10.1016/j.injury.2018.04.028 [doi]
PST - ppublish
SO  - Injury. 2018 Jun;49(6):1188-1192. doi: 10.1016/j.injury.2018.04.028. Epub 2018 
      Apr 24.