슬관절주위 외상에 의한 슬와동맥 손상의 재혈관화

Revascularization of Popliteal Artery Injury in Trauma Around Knee Joint

  • 한수홍 (포천중문 의과대학교 분당차병원 정형외과학교실) ;
  • 신동은 (포천중문 의과대학교 분당차병원 정형외과학교실) ;
  • 단진명 (구미차병원 정형외과학 교실) ;
  • 김철 (포천중문 의과대학교 분당차병원 정형외과학교실)
  • Han, Soo-Hong (Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University) ;
  • Shin, Dong-Eun (Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University) ;
  • Dan, Jin-Myung (Department of Orthopaedic Surgery, Kumi CHA Hospital) ;
  • Kim, Chul (Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University)
  • 발행 : 2008.05.31

초록

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

키워드