Background: Guidelines for the management of popliteal artery trauma emanat
e mainly from military experience. This study was undertaken to describe th
e management of popliteal injuries in a civilian vascular surgical unit wit
h a large trauma workload.
Methods: A retrospective review of records of patients treated between 1983
and 1997 was undertaken.
Results: Some 117 popliteal artery gunshot injuries were treated (83 low ve
locity, 16 high velocity, 18 shotgun), Associated fractures occurred in 44
patients and 40 had popliteal vein injuries. Treatment of the arterial inju
ry included vein graft interposition in 71, primary reanastomosis in 19, pr
osthetic graft interposition in four, lateral suture in one, vein patch in
one and ligation in one patient; 84 fasciotomies were performed. No periope
rative deaths occurred, There were 20 primary and 14 secondary amputations.
Factors associated with amputation were high-velocity injuries, delay in r
evascularization in excess of 7h, arterial transection, associated fracture
, and compartment syndrome or muscle infarction.
Conclusion: Civilian popliteal gunshot injuries are attended by a high ampu
tation rate, Prompt resuscitation and revascularization appear to be the on
ly correctable factors that may improve limb salvage rates.