PENETRATING INJURIES OF THE POPLITEAL ARTERY - THE BARAGWANATH EXPERIENCE

This study describes the management of 43 patients with penetrating in jury of the popliteal artery. Of these patients, 33 (76.5%) had bullet wounds, four patients (9.5%) pellet wounds and 6 (14%) knife wounds. Patients with 'hard' signs of arterial injury underwent exploration wi thout preoperative angiograms. There were no negative explorations. Pa tients with only 'soft' signs of arterial injury underwent preoperativ e angiograms. Of this group, 75% had positive angiograms and underwent exploration. There were no false-positive or false-negative preoperat ive angiograms in the group of patients with 'soft' signs in this stud y. Definitive orthopaedic management of associated fractures followed vascular reconstruction. There was no difference in the short-term pat ency of autologous saphenous vein graft as against PTFE grafts. Fascio tomy was performed on patients who had arterial and venous injury or p resented late. Overall amputation rate was 14% and for bullet injuries 18%.