Delayed presentation of traumatic popliteal artery pseudoaneurysms: A review of seven cases

Objectives: to examine the management and outcome of patients with traumatic popliteal artery pseudoaneurysms with delayed presentation. Materials: over a 2-year period 7 patients with traumatic popliteal pseudoaneurysms presenting to a tertiary referral unit after a delay of 1 month were reviewed. Methods: a retrospective review, of clinical records. Results: the median interval between injury and presentation was 1.5 months (range 1-24 months). Penetrating trauma from gunshot wounds was the cause of the initial vascular injury in 6 patients and a stab wound ill one. All patients had large pseudoaneurysms of more than 8 cm filling the popliteal fossa with variable degrees of fixed flexion deformity (FFD) of the knee. Severe FFD of more than 40degrees was noted in 2 patients and 3 others had mild flexion deformities of 10 to 20degrees. Six patients underwent repair of the pseudoaneurysms. One patient required all above knee amputation due to all infected false aneurysm. There were no deaths or graft related complications. Despite aggressivepost-operative physiotherapy only 2 patients were able to completely straighten the leg at the time of discharge. Conclusions: in patients with neglected popliteal artery pseudoaneurysms, morbidity is associated with the pre- operative degree of fixed flexion deformity of the knee.