"INDICATORS OF EXTREMITY SALVATION IN POPLITEAL AND TRIFURCATION ARTERIES' INJURIES"

Aim: Emergency surgical management in popliteal and triturcation artery injuries is aimed at salvation of the tunctional extremity. Long duration of ischemia and accompanying soft tissue, muscle-skeleton system, vein and nerve injuries are negative prognostic factors. We evaluated the effects of those factors in this study.

Materia l and Method: We studied 55 cases with traumatic popliteal and trifurcation arterial injury between 01. January.1995 and 31.December.2001 in our hospital. 46 were men (83.6%) and 9 were women (16.4%) with an age between 9 and 64 years (mean 28.6 years). Trauma was caused by cutting-perforating tools in 11 cases (20%), with tirearms in 35 cases (63%) and by traffic accidents in 9 (16.3%) cases .

Results: The average interval was 169 minutes for the patients to be admitted to our emergency service from the place of accident injury. We performed primary repair (end-to-end anastomosis, lateral repair) in 7(9.5%); saphenous vein patch plasty in 2(2.7%), reverse autologous saphenous vein interposition in 50(67.5%) synthetic graft interposition in 1(1.3%) and ligation in 14 (19%) of 74 arterial injuries. Secondary amputation was necessary in 5 cases (9%). Mortality was limited to 2 cases (2.6%).

Conclusiiın: We suggest that the most important factors to decrease morbidity and mortality are early and appropriate surgical intervention and preoperative and postoperative appropriate medical therapies.