<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000300217</article-id>
<article-id pub-id-type="doi">10.48750/acv.420</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Traumatic popliteal artery injury - a rare lesion that can&#8217;t be missed]]></article-title>
<article-title xml:lang="pt"><![CDATA[Lesão traumática da artéria poplítea: uma lesão rara mas que não pode ser esquecida]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coelho]]></surname>
<given-names><![CDATA[Nuno]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maximiano]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Evelise]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Semião]]></surname>
<given-names><![CDATA[Ana Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peixoto]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[Luís]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brandão]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canedo]]></surname>
<given-names><![CDATA[Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Vila Nova de Gaia Espinho Serviço Angiologia e Cirurgia Vascular ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>3</numero>
<fpage>217</fpage>
<lpage>222</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000300217&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000300217&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000300217&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Traumatic popliteal artery injury is a rare clinical entity, but it is the most common cause of amputation in injured extremities. The aim of this study was to report the incidence of popliteal artery injury after knee trauma and report therapeutic management and results.  Methods and material: ICD-10/ ICD-9 codes (S85.0/904.41; S83.1/836.5; S83.4; S83.5; S72,4/821.2; S82,1/823.0) were used to identify patients admitted with popliteal artery injury and/or knee trauma at our tertiary center from 1/1/2010 to 31/5/2021. A statistical analysis was realized using the SPSS program version27.  Results:  At our center from 1/1/2010 to 31/5/2021 535 patients were admitted due to knee trauma (28 with knee dislocation and 507 with fracture close to the knee) and 9 patients with popliteal artery injury (seven males, median age 39.0 years) The mechanism of PAI was motorcycle (4) or bicycle (1) or work (1) accidents (4); one fall, one running over and one iatrogenic injury. The incidence of PAI after knee trauma was 1.5%, after knee dislocation 17.9% and 0.8% after fracture close to the knee. Regarding associated injuries, four patients had severe soft tissue damage, two had venous injuries and two had nerve disruptions. The median ischemic time was 6.0 hours and mean vascular surgical time was 2.4 hours. Regarding vascular treatment, eight patients were submitted to bypass surgery and one was treated conservatively. Therapeutic fasciotomies were performed in three patients. No primary amputations were performed. A secondary major amputation was performed in one patient. The mean hospital length of stay was 24.9 days and mortality was 0%. Three patients returned to their normal activity level and six were limited in their daily activity.  Discussion/Conclusion:  The risk of PAI after knee dislocation is higher than after knee fracture (17,9% vs 0.8% in our study, and 3,4-8,2% vs 0,2 % in Swedish registration), so orthopedic surgeons must be aware of that increased risk, to avoid missing this diagnosis. The amputation rate in our serie was lesser than the Swedish registration and the United States National Trauma Data Bank (11% vs 28% and 14,5%, respectively). However, it´s still a high rate considering that it mostly affects a young and active population and only 33.3% patients return to a normal life. A multidisciplinary approach is essential to decrease ischemia time and to promote a holistic treatment.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: A lesão traumática da artéria poplítea, apesar de ser uma entidade clínica rara é a causa mais comum de amputação associada a trauma dos membros inferiores. O objetivo deste estudo foi descrever a incidência de lesão artéria poplítea após trauma do joelho e descrever a abordagem terapêutica e seus resultados.  Métodos e materiais:  Os códigos CID-10 / CID-9 (S85.0 / 904.41; S83.1 / 836.5; S83.4; S83.5; S72,4 / 821.2; S82,1 / 823.0) foram usados para identificar os pacientes admitidos no nosso centro terciário no período de 01/01/2010 a 31/5/2021 com o diagnóstico de lesão artéria poplítea e/ou trauma do joelho. Foi posteriormente realizada uma análise estatística destes pacientes através do programa SPSS versão 27.  Resultados:  No nosso centro no período de 1/1/2010 a 31/5/2021 foram admitidos 535 doentes com trauma do joelho (28 com luxação do joelho e 507 com fratura próxima ao joelho) e 9 doentes com lesão da artéria poplítea (7 homens, com idade mediana de 39,0 anos). Os mecanismos de lesão da artéria poplítea foram acidentes de mota (4) ou de bicicleta (1) ; um acidente de trabalho com maquinaria pesada, uma queda, um atropelamento e uma lesão iatrogénica. A incidência de lesão da artéria poplítea após trauma do joelho foi de 1.5% - após luxação do joelho foi de 17.9% e após fratura do joelho foi de 0.8%. Relativamente a lesões associadas, quatro doentes tinham lesões extensas de tecidos moles, dois tinham lesão venosa e dois tinham lesão nervosa. O tempo mediano de isquemia foi de 6.0 horas e o tempo médio de intervenção vascular de 2.4 horas. Em relação ao tratamento vascular realizado, oito doentes foram submetidos a cirurgia de revascularização por bypass e um foi tratado conservadoramente. Em três doentes foram realizadas fasciotomias terapêuticas. Não foi realizada nenhuma amputação primária e foi realizada uma amputação secundária. O tempo médio de internamento hospitalar foi de 24.9 dias e a mortalidade foi de 0%. Durante o follow-up, apenas três pacientes voltaram ao seu nível de atividade normal e seis ficaram com limitações na realização das atividades de vida diária.  Discussão/Conclusão:  O risco de lesão da artéria poplítea após luxação do joelho é maior do que após fratura do joelho (17,9% vs 0,8% no nosso estudo e 3,4-8,2% vs 0,2% no registo sueco) e, portanto, os ortopedistas devem estar conscientes deste risco aumentado de lesão vascular. A taxa de amputação na nossa série foi menor do que a do registo Sueco e a do Banco de Dados Nacional de Trauma dos Estados Unidos (11% vs 28% vs 14,5%, respetivamente). No entanto, 11% é ainda assim uma taxa elevada, uma vez que afeta principalmente uma população jovem e ativa e apenas 33.3% dos pacientes regressaram a uma vida normal. Assim sendo, uma abordagem multidisciplinar é essencial para diminuir o tempo de isquemia e promover um tratamento holístico do doente.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Popliteal artery injury]]></kwd>
<kwd lng="en"><![CDATA[knee trauma]]></kwd>
<kwd lng="en"><![CDATA[knee dislocation]]></kwd>
<kwd lng="en"><![CDATA[knee fracture]]></kwd>
<kwd lng="pt"><![CDATA[Trauma joelho]]></kwd>
<kwd lng="pt"><![CDATA[Luxação joelho]]></kwd>
<kwd lng="pt"><![CDATA[Fratura joelho]]></kwd>
<kwd lng="pt"><![CDATA[Lesão traumática da artéria poplítea]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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