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Predictors for saving the limb after popliteal artery injury
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Byoung Suck Kim, Woo Sig Kim, Byoung Hynn Min, Chang Hoon Jeon, Ye Yeon Won, Dae Woong Kim, Jae In Ahn
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J Korean Soc Fract 1999;12(4):879-884. Published online October 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.4.879
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 Abstract
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- PURPOSE
: This study had been performed to evaluate the factors affecting either saving the limb or amputation after popliteal artery injury associated with fractures or dislocation around the knee.
MATERIALS and METHODS
: Twelve patients of popliteal artery injury were included. Authors had analysed nine probable factors as follows - age, sex, injury mechanisms, injury types, interval between injury and time to arrive at the hospital, interval between injury and time of operation, surgical methods for revascularization, severity of extremity injuries and fasciotomy, for discrimination between the limb-saving group and the amputation.
RESULTS
Ten patients were arrived at the hospital within 48 hours after the injury. Each patient was managed by end-to-end anastomosis in 6 cases and autogenous vein graft in 4 cases and among them, 2 cases needed additional amputation for vascular compromise. All limbs could be saved in which cases operate within 6 hours after the injury. However, the limb was lost in one of 6 cases(16.7%) between 6 and 20 hours, in one of two cases(50%) over 20 hours. One of 7 cases(14.3%) with the Mangled Extremity Severity Score(MESS) of 2 to 4 points, two of 4 cases(50%) with MESS of 5 to 6 points and one(100%) with MESS of 7 points were amputated.
All 4 patients associated with fasciotomy could save their limbs, however, two of 6 patients not associated with fasciotomy lost.
SUMMARY : Authors thought the most reliable predictors for saving the limbs after the popliteal artery injury might include the MESS and fasciotomy, however, ischemic time more than 6 hours might not be an absolute indication for amputation.
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Pelvic Bone Fractures in Children
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Byoung Suck Kim, Ye Yeon Won, Weon Ik Lee, Myeong Ryeol Song, Jae In Ahn
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J Korean Soc Fract 1998;11(1):107-114. Published online January 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.1.107
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Abstract
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- The pelvic bone fractures in children were uncommon, except for avulsion injuries in the literature and authors had 21 cases of children's pelvic bone fracture, ranging from 1 to 15 years. The mode of injury, type of fracture, associated injuries, morbidity and mortality, and out-come were retrospectively analyzed. The majority of injuries were from automobile-pedestrian collisions (81.0%). the Torode and Zieg type IV injury had the greatest morbidity, mortality, and complications. sixteen patients had non-orthopedic, associated injuries and fourteen required blood transfusions within initial 48 hours after injury. Two of them passed away due to hematologic unstableness. Twenty patients were managed by conservative method, except for one operative case by using of an external fixation device. This study included only 13 cases had average 1 year of follow-up. One acetabular dysplasia of 5 acetabular fractures was found at 12 months after injury. The nonoperative approach for the pelvic bone injury has had a satisfactory outcome in our hospital. so, authors think that if conservative methods will be properly applied, it may be one of the methods of treatment for the children's pelvic bone fracture. Even though there is no symptoms, long-term follow-up will be inevitable for checking more severe acetabular dysplasia and leg length discrepancy.
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