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Review
. 2020 Jan 30;21(1):59.
doi: 10.1186/s12891-020-3089-8.

Popliteal artery transection associated with a minimally displaced tibial plateau fracture: a case report and review of the literature

Yan-Wei Liu  1 , Yan-Hui Li  2 , Tiecheng Yu  1 , Tianye Yang  3 , Yuying Li  4 , Lei Tan  5
Affiliations
Review

Popliteal artery transection associated with a minimally displaced tibial plateau fracture: a case report and review of the literature

Yan-Wei Liu et al. BMC Musculoskelet Disord. .

Abstract

Background: Poplital artery transection injury is potentially catastrophic, or even life-threatening. Severe traumas, including open fracture, gunshot, stabs, and knee dislocation and complex fracture of proximal tibia or distal femur, are the common causes of high rate of amputation due to popliteal artery trauma. No report mentions vascular injury associated with minimally displaced tibial plateau fracture in adult.

Case presentation: A 30-year-old male presented with popliteal artery transection injury associated with minimally displaced tibial plateau fracture. He presented to emergency department, 6 h after fall from ground into a 1-m height hole. Physical examination suggested acute ischemia, with signs of paleness, coldness, anesthesia, hemorrhagic bullae below the right knee level. There was severe swelling and ecchymosis in popliteal fossa and around the leg with significant calf tenderness and pedal edema. Tibialis posterior, dorsalis pedis, and popliteal arterial pulses were not palpable. Radiograph suggested minimally displaced tibial plateau fracture with no evidence of knee dislocation. The patient was taken up for emergency surgery after consultation with vascular surgeon. During the closed reduction external fixation and compartment decompression, popliteal artery trunk was found transected and end-to-end repair was performed. During the post-operational period, no complication was developed and the patient was followed-up for 1 year. At the one-year follow-up, he acquired good stability of his right knee with full range of motion.

Conclusion: Significant swelling and ecchymosis should alert the surgeons to the possibility of vascular injury in knee joint injury, even if there is no fracture or dislocation, or fracture is minimally displaced.

Keywords: Minimally displaced; Popliteal artery transection; Tibial plateau fracture.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
An oblique fracture, involving the tibial spines, medial and lateral surfaces of the tibal plateau illustrated in an anteroposterior (left), and lateral radiographs (right)
Fig. 2
Fig. 2
Postoperative radiographs. The fracture was fixed with external fixator
Fig. 3
Fig. 3
Intraoperative picture of lateral(left) and medial(right) incision of compartment decompression
Fig. 4
Fig. 4
Popliteal artery transection (blue triangle) was observed intraoperatively
See this image and copyright information in PMC

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