Arterial Injuries in Orthopaedics: The Posteromedial Approach for Vascular Control About the Knee

• Published in: Journal of orthopaedic trauma Vol. 10; no. 7; pp. 476 - 480
• Main Authors: Muscat, Jay O, Rogers, Waid, Cruz, Anatolio B, Schenck, Robert C
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01-01-1996; Lippincott Williams & Wilkins
• Subjects: Adolescent; Adult; Biological and medical sciences; Humans; Knee Injuries - complications; Knee Joint - blood supply; Knee Joint - diagnostic imaging; Knee Joint - physiology; Male; Medical sciences; Middle Aged; Popliteal Artery - injuries; Popliteal Artery - surgery; Radiography; Range of Motion, Articular; Saphenous Vein - transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular Surgical Procedures - methods; Wounds, Gunshot - surgery; Human; Diseases of the osteoarticular system; Check; Lower limb; Cardiovascular disease; Popliteal artery; Trauma; Vascularization; Vascular disease; Arterial disease; Knee disease; Association; Treatment; Surgery; Posterior; Surgical approach; Diagnosis
• ISSN: 0890-5339; 1531-2291
• DOI: 10.1097/00005131-199610000-00005

SUMMARYCombined orthopaedic and vascular injuries are becoming more common owing to an increasing incidence of high-energy trauma and gunshot wounds. We present our experience using the posteromedial approach in treating eight orthopaedic patients with popliteal arterial injuries. All patients underwent popliteal exploration by a vascular surgeon through a posteromedial approach (releasing the pes anserinus and the medial gastrocnemius). The arterial injuries were reconstructed in five patients using a reverse saphenous vein graft and directly repaired in three patients. Two patients had delayed healing of their incisions as a result of the original injury. There were no neural injuries. The posteromedial approach is extensile and utilitarian, and it represents the exposure of choice for arterial injuries about the knee.