Popliteal Artery Injuries in Motorcycle Accidents Following Posterior Knee Dislocation: Surgical Outcomes of Saphenous Vein Graft Repair — A Single-Center Case Series from Nishtar Hospital, Multan

Abstract

Objective: To assess the surgical outcomes and early functional recovery of patients undergoing great saphenous vein graft repair for popliteal artery injuries following posterior knee dislocations caused by motorcycle accidents.
Study Design: Descriptive case series.
Place and Duration of Study: Plastic Surgery and General Surgery Departments, Nishtar Hospital, Multan, from January 2021 to December 2024.
Methodology: This study included 21 male patients aged 12 years and older who sustained posterior knee dislocations due to motorcycle-related trauma. All patients had intraoperatively confirmed injuries to the popliteal artery and underwent arterial reconstruction using reversed autologous great saphenous vein grafts. Fasciotomy and orthopedic stabilization were performed as required. Patients who presented more than 12 hours after trauma with non-viable limbs or incomplete follow-up data were excluded. Graft patency was evaluated with Doppler ultrasonography on days 2 and 7, and with CT angiography at six months. Functional outcomes were assessed at 12 weeks using the Lower Extremity Functional Scale (LEFS).

Results: All patients achieved limb salvage, with no amputations recorded. Graft patency at six months was confirmed in all cases. The mean LEFS score was 65.0 ± 4.1, with 18 patients (85.7%) achieving scores of 60 or higher, reflecting satisfactory recovery. Postoperative complications occurred in 5 patients (23.8%) and included wound infection, early graft thrombosis, seroma, and wound dehiscence—all managed conservatively.
Conclusion: Timely revascularization using reversed saphenous vein grafts offers excellent outcomes in terms of limb salvage, graft durability, and early functional recovery in patients with motorcycle-related popliteal artery injuries.