Popliteal Artery Injuries: Incidence, Clinical Patterns and Outcomes (A Single Center Study in Yemen)

Abstract

Background: Below the inguinal ligament, popliteal artery injuries are the second most frequent arterial injuries in the world. In order to share our experience with complex traumatic popliteal vascular injuries at Al-Thawra Modern General Hospital in Sana’a City- Yemen, we focus on the incidence, initial presentation, surgical management, and outcomes of popliteal artery injuries. Patients and Methods: Over the 3-year period from 1 January 2020 to 31 December 2022, all patients with popliteal artery injuries regardless of their other synchronized injuries were included. By contrast, patients who are managed as popliteal artery injuries by a military care giver at battle field were excluded from our analysis. In the diagnosis of popliteal artery injury, we relied on the physical examination. The main outcome was either patients get complete recovery, partial function loss of the limb, or end with amputation. Results: During study period, an overall incidence of popliteal artery injuries was 0.9%. Of 26 patients with popliteal artery injuries, 25 (96.2%) patients were men, and more than half of our patients (53.8%) were in the age group ≤ 25 years, with an overall mean of age 24.5 ± 5.6 years. The distribution of patients in groups of time delays in treatment of ≤ 6 hours, 6-10 hours and more than 10 hours was 9 (34.6%), 12 (46.2%) and 5 (19.2%) respectively. The mechanisms of injury were penetrating and blunt in 24 (92.3%) and 2 (7.7%) patients respectively. Patients who received a fasciotomy was 25 (96.2%). In our cohort of patients, incidence of amputation was 11.5%, while partial function loss rate was 27%. Conclusion and Recommendations: In our cohort of patients, incidence of popliteal artery injuries was high. Despite technical improvements in management of popliteal artery injury, a high amputation rate is observed in our study. The need for early diagnosis and early referral to definitive care must be emphasized. One of the most important ways to lower the risk of amputation is to shortening the duration of ischemia.