Abstract

Purpose

This study aims to identify multiple ligament knee injury patterns that possess a high-risk of vascular lesion.

Methods

We retrospectively compared torn ligament patterns and the presence of vascular lesions confirmed by magnetic resonance imaging and computed tomography angiography from 122 consecutive patients with diagnoses of multiple ligament knee injury made at the emergency department between January 2012 and December 2017. Patients were not eligible if they had an ipsilateral lower extremity lesion (dislocations or fractures at another level), initial evaluation at another hospital, or follow-up for less than 12 months. The primary outcomes were the comparison between the imaging findings of torn structures patterns and the presence of a vascular lesion.

Results

We identified 48 eligible patients (50 knees) with multiligamentary knee lesions, of whom eight had popliteal artery damage, yielding an incidence of 16%. Our clinical examination detected six of these patients that were classified, according to the Schenck system, as KD-IIIL (6 knees) and KD-IIIM (2 knees). The odds of having a popliteal artery injury is 4.69 to 1 with a KD-IIIL injury that with any other type of injury on that classification (95% CI 0.960–22.98).

Conclusions

This data suggests that varus forces causing enough energy to produce a KD-IIIL lesion possess a higher popliteal artery injury risk, making recommendable a thorough examination of the vascular integrity when diagnosing a KD-IIIL lesion.

中文翻译：

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内翻机制与多韧带膝关节损伤中of动脉病变的高发有关。

摘要

目的

这项研究旨在确定具有高血管病变风险的多条韧带膝关节损伤模式。

方法

我们回顾性比较了2012年1月至2017年12月在急诊科连续122例诊断为多韧带膝关节损伤的患者的韧带撕裂模式和通过磁共振成像和计算机断层扫描血管造影证实的血管病变的存在。患有同侧下肢病变（处于另一水平的脱位或骨折），在另一家医院进行初步评估或随访少于12个月。主要结果是在撕裂的结构图案的影像学表现与血管病变的存在之间进行比较。

结果

我们确定了48例多韧带膝关节损伤的合格患者（50个膝盖），其中8例受pop动脉损伤，发生率为16％。我们的临床检查发现，根据Schenck系统，其中有6名患者被分类为KD-IIIL（6膝）和KD-IIIM（2膝）。伴有其他任何类型的KD-IIIL损伤，发生pop动脉损伤的几率是4.69比1（95％CI 0.960-22.98）。

结论

该数据表明，引起足够能量产生KD-IIIL病变的内翻力具有较高的pop动脉损伤风险，因此建议在诊断KD-IIIL病变时彻底检查血管完整性。