Also, four (10%) patients suffered from penetrating type of trauma. Out of 40 patients, 26 (65%) were operated using interposition vein graft technique, and 14 (35%) cases with popliteal artery trauma were subjected to femoropopliteal bypass graft technique. The rate of primary amputation in patients managed by femoropopliteal bypass was 2/14 (14%), but that in patients managed using interposition vein graft technique was 4/26 (15.4%) (P=0.926). The rate of secondary amputation among patients with popliteal trauma managed using femoropopliteal bypass was 3/14 (21.4%) compared to the rate of 12/26 (46%) among the Inhibitors,research,lifescience,medical cases managed by interposition vein graft (P=0.123). Knee

stability was maintained in 12/14 (85.7%) of patients managed by femoropopliteal bypass graft compared to the rate of 15/26 (85.7%) among the ptients managed by interposition graft (P=0.405). No patient died during the operations. The mean period of hospitalization Inhibitors,research,lifescience,medical was eight days. Discussion

Traumatic popliteal artery injuries are uncommon, but they are highly lethal injuries.4,8 Regardless of whether the injury is caused by blunt or penetrating trauma, the majority of the patients Inhibitors,research,lifescience,medical need immediate surgical intervention.4,8,9 Urgent surgical graft replacement is the standard emergency treatment in order to prevent popliteal artery rupture and death, but the surgical risk is high because these patients frequently have multiple other associated major traumatic Inhibitors,research,lifescience,medical injuries.5,10 In critical injuries, successful results were obtained by arterial reconstruction procedures which were performed within 6-8 hours after the event. Most of vascular surgeons working on patients injured in the war field or civilian trauma units did repair the cases of popliteal artery trauma cases of popliteal artery trauma without using grafts.6,11 Rich and colleagues,7 Inhibitors,research,lifescience,medical from Vietnam Vascular Registery, who had experience on popliteal artery

injury, advocated a progressive approach towards venous repair. Later on, through another study Bermudes et al.12 showed that after ligation and repair of vascular injury in vessels of lower extermites, there was a late complication of venous insufficiency. Fasciotomy or complex venous repair were also comlicated with maximal functional disturbances.8 Therefore, in order to avoid such complications in the patients with popliteal artery injuries in the present study, we used the techniques of interposition graft in some cases Selleck CX-5461 and fomoropopliteal bypass in others. The experience gained by the managemnet of a large number of vascular injuries during the war has BIBW2992 chemical structure resulted in a remarkable decrease of the limb amputation by our surgical team. However, the rate of limb loss is still high in civilian injuries.3,4,9 Vascular repair preceded orthopedic fixation. Arterial continuity was restored by using autogenous saphanus vein graft. The regular surgical management of popliteal vascular injury was the exploration of popliteal fossa.