Povreda poplitealne arterije nakon traumatske dislokacije zgloba kolena kod 14-godišnjeg dečaka: prikaz bolesnika i pregled literature

  • Slobodan Cvetković Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery,Clinical Centre of Serbia, Belgrade, Serbia
  • Nenad Jakoviljević Clinic for Vascular and Endovascular Surgery,Clinical Centre of Serbia, Belgrade, Serbia
  • Dušica Simić Clinic for Vascular and Endovascular Surgery,Clinical Centre of Serbia, Belgrade, Serbia; University Children Hospital Belgrade, Belgrade, Serbia
  • Miloš Sladojević Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ljubomir Djurašić Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade, Serbia
  • Lazar Davidović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery,Clinical Centre of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.2298/2664
Ključne reči: knee injuries||, ||koleno, povrede, popliteal artery||, ||a. poplitea, blood vessels||, ||krvni sudovi, wounds and injuries||, ||povrede, child||, ||deca, vascular surgical procedures||, ||hirurgija, vaskularna, procedure, transplants||, ||graftovi, recovery of function||, ||funkcija, povratak,

Sažetak


Uvod. Zadnja dislokacija zgloba kolena praćena povredom poplitealne arterije kod dece veoma je retko stanje. Brza dijagnoza i lečenje ključni su za očuvanje kako samog ekstremiteta tako i njegove funkcije. Prikaz bolesnika. Prikazali smo 14-godišnjeg dečaka koji je pretrpeo iščašenje desnog kolena i kontuziju poplitealne arterije u saobraćajnoj nesreći na motociklu. Dijagnoza je potvrđena doplerom i ultrazvučnim dupleks pregledom i digitalnom suptrakcionom transfemoralnom arteriografijom. Urađena je hitna hirurška procedura zadnjim pristupom poplitealnoj arteriji. Tokom hirurške eksploracije pronađena je ruptura zadnjeg ukrštenog ligamenta udružena sa trombozom zatkolene arterije. Oštećena poplitealna arterija resecirana je i zamenjena autolognim safenskim venskim graftom. Poslednji korak hirurške procedure bio je transosealna femoralna fiksacija zadnjeg ukrštenog ligamenta. Trogodišnji postoperativni period praćenja pokazao je intaktnu arterijsku perfuziju i veoma dobru funkciju kolena sa neznatnom razlikom u odnosu na suprotno koleno. Zaključak. Komplikovane ortopedske i vaskularne povrede kod dece su veoma retke i zahtevaju multidisciplinaran pristup.

Reference

Barmparas G, Inaba K, Talving P, David JS, Lam L, Plurad D, et al. Pediatric vs adult vascular trauma: a National Trauma Da-tabank review. J Pediatr Surg 2010; 45(7): 1404−12.

Hesse E, Bastian L, Zeichen J, Pertschy S, Bosch U, Krettek C. Femoral avulsion fracture of the posterior cruciate ligament in association with a rupture of the popliteal artery in a 9-year-old boy: a case report. Knee Surg Sports Traumatol Arfthrosc 2006; 14(4): 335−9.

Janousek AT, Jones DG, Clatworthy M, Higgins LD, Fu FH. Poste-rior cruciate ligament injuries of the knee joint. Sports Med 1999; 28(6): 429−41.

Kirby L, Abbas J, Brophy C. Recanalization of an occluded pop-liteal artery following posterior knee dislocation. Ann Vasc Surg 1999; 13(6): 622−4.

Armstrong PJ, Franklin DP. Treatment of vascular injuries in themultiple-ligament-injured knee. Operat Techniq Sports Med 2003; 11(3): 199−207.

Viswanath YK, Rogers IM. A non-contact complete knee dislo-cation with popliteal artery disruption, a rare martial arts injury. Postgrad Med J 1999; 75(887): 552−3.

Perron AD, Brady WJ, Sing RF. Orthopedic pitfalls in the ED: vascular injury associated with knee dislocation. Am J Emerg Med 2000; 19(7): 583−8.

Kwolek CJ, Sundaram S, Schwarcz TH, Hyde GL, Endean ED. Popliteal artery thrombosis associated with trampoline injuries and anterior knee dislocations in children. Am Surg 1998; 64(12): 1183−7.

Hagino RT, DeCaprio JD, Valentine RJ, Clagett GP. Spontaneous popliteal vascular injury in the morbidly obese. J Vasc Surg 1998; 28(3): 458−62.

Aitken AP. Fractures of the proximal tibial epiphysial cartilage. Clin Orthop Relat Res 1965; 41: 92−7.

Burkarht SS, Peterson HA. Fractures of the proximal tibial epiphysis. J Bone Joint Surg Am 1979; 61(7): 996−1002.

Margheritini F, Mariani PP. Diagnostic evaluation of posterior cruciate ligament injuries. Knee Surg Sports Traumatol Ar-fthrosc 2003; 11(5): 282−8.

Harrel DJ, Spain DA, Bergamini TM, Miller FB, Richardson JD. Blunt popliteal artery trauma: a challenging injury. Ann Surg 1997; 63(3): 228−31.

Plorde JJ, Patel HA, Hunter JC. Knee dislocation with suspected popliteal artery deisruption. AJR Am J Roentgenol 1997; 168(2): 558.

Wagner WH, Calkins ER, Weaver FA, Goodwin JA, Myles RA, Yellin AE. Blunt popliteal artery trauma: one hundred con-secutive injuries. J Vasc Surg 1988; 7(5): 736−43.

Harner CD, Höher J. Evaluation and treatment of posterior cru-ciate ligament injuries. Am J Sports Med 1998; 26(3): 471−82.

Godrich A, Billard A. Posterior cruciate ligament aqvulsion as-sociated with ipsilateral femur fracture in a 10-year-old child. J Trauma 1998; 28(9): 1393−6.

Eady JL, Cardenas CD, Sopa D. Avulsion of the femoral at-tachment of the anterior cruciate ligament in a seven-year-old child. A case report. J Bone Joint Surg Am 1982; 64(9): 1376−8.

Martinez D, Sweatman K, Thompson EC. Popliteal artery injury associated with knee dislocations. Am Surg 2001; 67(2): 165−7.

Kwolek CJ, Sundaram S, Schwarcz TH, Hyde GL, Endean ED. Popliteal artery thrombosis associated with trampoline injuries and anterior knee dislocations in children. Am Surg 1998; 64(12): 1183−7.

Downs AR, Macdonald P. Popliteal artery injuries: civilian ex-perience with sixty-three patients during a twenty-four year pe-riod (1960 through 1984). J Vasc Surg 1986; 4(1): 55−62.

Snyder WH. Vascular injuries near the knee: an updated series and overview of the problem. Surgery 1982; 91(5): 502−6.

Klineberg EO, Crites BM, Flinn WR, Archibald JD, Moorman CT. The role of arteriography in assessing popliteal artery injury in knee dislocations. J Trauma 2004; 56(4): 786−90.

Davidović L, Lotina S, Kostić D, Velimirović D, Dukić P, Cinara I, et al. Popliteal artery war injuries. Cardiovasc Surg 1997; 5(1): 37−41.

Eren N, Ozgen G, Ener BK, Solak H, Furtun K. Peripheral vascu-lar injuries in children. J Pediatric Surg 1991; 26(10): 1164−8.

de Virgilio C, Mercado PD, Arnell T, Donayre C, Bongard F, White R. Noniatrogenic pediatric vascular trauma: a ten-year experience at a level I trauma center. Am Surg 1997; 63(9): 781−4.

Lazarides MK, Georgiadis GS, Papas TT, Gardikis S, Maltezos C. Operative and nonoperative management of children aged 13 years or younger with arterial trauma of the extremities. J Vasc Surg 2006; 43(1): 72−6.

Dalsing MC, Cikrit DF, Sawchuk AP. Open surgical repair of children less than 13 years old with lower extremity vascular injury. J Vasc Surg 2005; 41(6): 983−7.

Lineen EB, Faresi M, Ferrari M, Neville HL, Thompson WR, Sola JE. Computed tomographic angiography in pediatric blunt traumatic vascular injury. J Pediatr Surg 2008; 43(3): 549−54.

Angiletta D, Impedovo G, Pestrichella F, Marotta V, Perilli F, Regina G. Blunt femoropopliteal trauma in a child: is stenting a good option. J Vasc Surg 2006; 4(1): 201−4.

Objavljeno
2015/04/21
Broj časopisa
Vol. 71 Br. 1 (2014)
Rubrika
Prikaz bolesnika