Popliteal Artery Injury in Knee Dislocations

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Missed Popliteal Artery Injury After Knee Dislocation

Anatomy of the Popliteal Artery
The popliteal artery runs behind the knee, originating from the femoral artery. Its fixed ends and mobile middle section make it vulnerable during knee dislocation.

Incidence of Popliteal Artery Injury
Occurs in one point six percent to sixty-four percent of knee dislocations. High suspicion needed due to potentially devastating outcomes.

Mechanism of Injury
High-energy forces during knee dislocation can stretch, tear, or completely transect the popliteal artery due to its anatomical position.

Challenges in Diagnosis
Three main challenges:
Deep anatomical location makes direct examination difficult
Collateral circulation can mask injury
Pain and swelling complicate assessment

Clinical Presentation
Key signs to assess:
Absent/diminished pulses, cool/pale foot
Delayed capillary refill
Sensory deficits and motor weakness

Assessment Methods
Physical exam:
Detailed injury history
Compare affected limb to opposite side
Ankle-brachial index below zero point nine suggests compromise

Imaging Studies
Three main imaging options:
Doppler ultrasound for blood flow
Computed Tomography Angiography (gold standard)
Conventional angiography for surgical planning

Early Surgical Consultation
Immediate vascular surgeon consultation required for suspected injury. Surgical intervention may include thrombectomy, repair, or bypass.

Potential Complications
Delayed diagnosis can lead to:
Limb ischemia and possible amputation
Compartment syndrome
Long-term disability
Remember: Time is muscle in vascular trauma!