Treatment of traumatic lesions of popliteal artery by staged stretching

Abstract

Objective To investigate the clinical effects of treating traumatic lesions of the popliteal artery by staged stretching. Methods From July 2011 to March 2016, 29 patients with traumatic lesion of the popliteal artery underwent staged stretching after direct end to end anastomosis at Department of Or-thopaedics, The 9th People’s Hospital of Wuxi. They were 19 males and 10 females, with a mean age of 38.3 years (range, from 16 to 61 years). The average length of popliteal artery lesions was 3.7 cm (range, from 2 to 5 cm). After the keen joint was immobilized at flexion by external fixation, direct end to end anastomosis was performed with a proper segmental vascular freedom. From 4 weeks after operation, the popliteal artery was stretched stage by stage to its original length by gradual adjustment of the external fixation till the knee joint was fully extended. The color, skin temperature, pulp tension and capillary reaction of the toes were closely observed after surgery. CT angiography (CTA) was performed 6 months after surgery. The active range of motion was assessed at 12 months after surgery for the knee and ankle joints on the injured limb. Results All the patients were available for an average follow-up of 2 years (range, from 1 to 3 years). Blood supply was good for all the affected limbs. The staged stretching of the popliteal artery resulted in no rupture of any anastomotic stoma or no thrombus. CTA at 6 months after surgery showed fine patency of the popliteal artery and no formation of false aneurysm or arteriovenous fistula. At 12 months after surgery, the knee function was excellent in 15 cases, good in 10 and fair in 4; the ankle function was excellent in 18 cases, good in 8 and fair in 3. Conclusion Staged stretching is a safe, convenient and effective treatment of traumatic lesions of the popliteal artery. Key words: Popliteal artery; Knee injuries; Ankle injuries; Staged stretching