High rate of popliteal artery injuries and limb loss in 96 knee dislocations

Abstract

Background: Knee dislocations are reported to have an incidence of popliteal artery injuries between 7% and 64%. The purpose of this study was to determine the incidence of injuries to the popliteal artery as well as early limb loss in knee dislocations at a level-1 trauma hospital in South Africa. Methods: Twenty-eight patients with popliteal artery injuries were selected from a prospectively collected database of 96 patients with acute knee dislocations. The incidence of vascular injuries, compartment syndromes and limb loss was determined retrospectively. Results: Of 96 knee dislocations 28 had a popliteal artery injury (29.1%). Seven of 28 patients with popliteal artery injuries needed an amputation. Of the 28 patients, ten were documented as a threatened limb. Five of these ten patients (50%) needed an amputation. The documented median delay to revascularisation of patients who presented with threatened limbs was 10 hours. Conclusion: Overall, one-third of knee dislocations presented with a vascular injury. The prevalence of amputa - tions in knee dislocations with associated popliteal artery injuries was 25% and increased to more than 50% in patients who presented with a threatened limb.