闭合性膝关节周围骨折脱位伴腘动脉损伤

Popliteal artery injuries associated with closed fractures and dislocations about the knee

目的探讨了闭合性膝关节周围骨折脱位伴腘动脉损伤的早期诊断特点。方法回顾性分析了32例闭合性膝关节周围骨折脱位伴腘动脉损伤的临床特点,并进行了手术修复。结果32例患者平均随访16个月,27例肢体成活,5例截肢。血管完全断裂9例,部分断裂11例,血管痉挛4例,血管严重挫伤并栓塞6例。结论这类损伤有较强的隐蔽性,容易被误诊和漏诊,伤情严重;血管损伤类型多样、复杂,合并伤多,预后差。对闭合性膝关节周围骨折脱位患者,应高度警惕发生腘动脉损伤的可能性。

Objective To study the features of early diagnosis of the popliteal artery injuries associated with closed fractures and with surgical repair. Methods 32 patients of popliteal artery injunes associated with closed fractures and dislocations the knee were analyzed. Results All of the 32 patients were followed up for a mean of sixteen months after injury. 27 patients had survival limbs, and 5 patients had been amputated. Nine had complete vascular rupture, eleven had part vascular rupture, four had mild vascular spasm,and six had severe vascular contusion and embolism. Conclusion This injury has stronger invisibility,results in easy delay and missed diagnosis. The condition of an injury is severe,and vascular traumatic types is various and complex. It has many associat ed injuries and a poor prognosis. We should keep fully alert to closed fractures and dislocations about the knee,in which the poplite al artery can be injuried.