TRAUMATIC POPLITEAL AND TRIFURCATION ARTERIAL INJURIES - HOW CAN WE PREDICT THE ULTIMATE OUTCOME

During a sixteen-year period ending in March 1993, 63 patients with 88 popliteal or trifurcation arterial injuries underwent surgical manage ment, and the ultimate outcome was recorded according to both mangled extremity severity score (MESS) and risk classification at Dicle Unive rsity. There were 14 major (22.2%) and 3 minor (4.8%) amputations and 4 (6.3%) deaths. Of 40 patients with an ischemic period of more than e ight hours, 13 required amputation. According to MESS, there were 28 p atients with scores of 7 or more (44.4%). In this group 13 patients re quired amputation (46.4%), and 8 had a good outcome (28.6%). As regard s patients' classification by risk factors of nerve injury, soft-tissu e injury, and open fracture, 15 of 17 patients having one or less risk factor had a good outcome (88.2%), whereas 20 of 46 patients having t wo or more risk factors had good outcome (43.5%). A comparison of pati ents having one or less risk factor with those having three risk facto rs found statistical significance according to amputation rates (P < 0 .05). The difference in amputation rates between 23 patients who were operated on within less than eight hours and 40 patients who were oper ated on within more than eight hours was statistically nonsignificant (P > 0.05).