Background: Popliteal artery injuries have been associated with highest rates of amputations after lower extremity vascular injuries. Early diagnosis of vascular injury, early revascularization of the ischemic limb and management of concomitant injuries are the key factors in preventing morbidity or mortality in such cases. The aims and objective
of this study is to evaluate outcome following civilian popliteal vascular injury and identification of predicting factors for amputation.

Material and methods: Retrospective data of 80 patients over 5 yrs from January 2012 to December 2017 period was collected for patients admitted with popliteal artery injury with or without concomitant bone or other systemic injury. Patient’s age, sex, mode of injury, mangled extremity severity score (MESS), associated venous and or neural
injuries and other physiological parameters assessed. Time to operative intervention, requirement of multiple (more than 2) blood transfusions, other orthopedic or systemic injuries requiring need for concomitant other surgical intervention, timing of orthopedic intervention pre or post vascular interventions and outcome in the form of amputation or in hospital mortality were recorded.

Results: We studied 80 patients with civilian popliteal artery injury with median age of 35 yrs (range 8 to 65 yrs.) the median MESS was 6. Mechanism of injury was blunt for 58% and penetrating for 42%. Fasciotomy was performed in 80% of patients. Out of all 80 patients 56 patients (70%) patients underwent concomitant orthopedic
surgical intervention of which 52 patients had undergone orthopedic intervention prior to vascular surgery. Higher rates of amputation were noted for patients with MESS more than 7, patients with poly trauma and patients presented to surgery after 12 hrs of trauma. Patients requiring multiple blood transfusions, age more than 50 and associated comorbid conditions had highest mortality rates.

Conclusion: Popliteal artery trauma is a major source of patient morbidity and is important cause of amputation after injuries to the lower extremity. Blunt trauma, Higher MESS, associated bony injuries requiring surgical intervention are important predictors of amputation but associated venous or neural injuries have no role as predictor of amputation. Higher blood transfusion requirement and concomitant other systemic injuries requiring surgical interventions have high risk of in hospital mortality. Timing of orthopedic intervention pre or post vascular repair does not impact clinical outcome.