Ramdass et al identified risk factors for amputation in a patient with trauma to the popliteal artery. These can help to identify a patient who may require more aggressive managment. The authors are from the University of the West Indies in St. Augustine, Trinidad.

Patient selection: popliteal artery trauma


Trauma may be penetrating (gun shot wound, stab wound) or blunt (fall, motor vehicle accident). The amputation rate was 25% for penetrating wounds and 33% for blunt trauma.


Risk factors for amputation:

(1) trauma to artery and vein or artery, vein and nerve

(2) concomitant fracture or dislocation (orthopedic injury) in the same leg

(3) delayed transfer to vascular surgery (includes delay in diagnosis)

(4) large calf muscle mass (may shorten time to critical ischemia)


The risk for amputation increases with the number of risk factors present.

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