- 期刊
Is Arteriography Necessary for the Evaluation of Traumatic Knee Dislocation?
動脈攝影在外傷性膝關節脫臼中是否必要？
摘要
外傷性膝關節脫臼常伴隨著膕動脈損傷，如果延遲處理可能會導致嚴重的後遺症。例行性使用動脈攝影來評估膕動脈仍具爭議性。我們收集1991年到1997年間11個外傷性膝關節脫臼的病例。其中一個患者伴隨有患肢冰冷、脈搏消失、感覺異常。在動脈攝影中顯示出遠端膕動脈受損，並隨即接受外科手術治療。其餘患者並無缺血證據，這些患者最初接受保守性治療及使用臨床檢查來監控，並未接受動脈攝影。所有患者最少在醫院觀察72小時，而且住院期間並無血管受損的現象。在出院之後，所有患者經過追蹤檢查，並無任何延遲性的後遺症。我們認為保守性療法及密切的理學檢查是外傷性膝關節脫臼最佳處理方式。若理學檢查顯示在遠端肢體並無異常徵候，靜脈攝影是不需要的。
並列摘要
Traumatic knee dislocation is associated with a high incidence of popliteal artery injury and may result in serious complications if there is a delay in treatment. Routine arteriography in evaluation of traumatic knee dislocation is still controversial. We reviewed 11 cases of traumatic knee dislocation from 1991 through 1997. One of the patients had a cold, pulseless limb with paresthesia. Arteriography revealed distal popliteal artery occlusion and the patient received operative therapy immediately. The others showed no evidence of ischemia at the time of admission. They received conservative treatment initially and were monitored by clinical examination without arteriography. All patients were observed for at least 72 hours in the hospital and no evidence of vascular injury was noted during their hospital stay. Regular followup was performed after discharge and none of the patients had any serious delayed complications. We conclude that careful physical examination and conservative treatment are adequate for managing most of the patients with traumatic knee dislocations. Arteriography is necessary only for patients with abnormal physical findings that indicate vascular insult on the distal extremities.