Arterial Injuries associated with Fractures or Dislocations around the Knee

Oh, Chang Wug; Ihn, Joo Chul; Park, Byung Chul; Park, Il Hyung; Kim, Shin Yoon; Kim, Hee Soo

Abstract

The purpose of this article is to delineate factors important in successful management and subsequent extremity function of the patient with arterial injury associated with fractures or dislocations around the knee. We reviewed 25 cases of arterial injury associated with fractures or dislocations around the knee which were treated at our hospital between 1994 and 1998. As long term results, the salvage rate of the lower limb was related to the extent of the soft tissue damage and the severity of infection, but there was no statistical difference according to the method of vascular surgery(p=0.645). Compared with the salvage rate of the lower limb according to the length of time from injury to vascular reanastomosis, there was no statistical difference between two groups of the patients who were operated within 12 hours and were operated during the time between 12 hours and 24 hours(p=0.084). In view of whether open or closed fractures were combined, 1 I cases(58%) among 19 cases of open fractures and 5 cases(83%) among S cases of close(1 fractures were able to salvage the lower limb, so it could contributes to the sdlvdge rate of the limb. Finally 16 cases(64%) among total 25 cases were able to salvage the lower limb, and its functional outcome was like followings : excellent results were found in 6 cases, fair results in 8 cases, poor results in 2 cases, and amputation in 9 cases(36%). In case of amputation, 3 cases were primarily amputated and 6 cases were amputated secondary to vascular surgery . As long term results, whether open or closed fractures were combined, the teverity of the infection and the extent of the soft tissue necrosis were the factors influencing on the falvage rate of the lower limb. Other factors, such as the difference of ischemic time within 24 hours interval, the site and the method of management of the fractures and the vascular injuries and whether fasciotomy was performed or not were not important factors influencing on the salvage rate of the lower limb.