Revista de Medicina Desportiva (English) March 2018 | Page 33

shock, he underwent amputation
above the left knee 37 days later. No
intercurrences were noted in the
postoperative period, with a clinical
and analytical recovery.
After six months, he presented a
healed amputation stump and was
placed in a functional rehabilitation
program.
Discussion
Dislocation of the knee with associ-
ated neurovascular injury is a seri-
ous and potentially threatening limb
problem. 1,11 It is of utmost impor-
tance to diagnose vascular injury as
early as possible and the following
clinical signs should be investigated
promptly:
• absence of pedal and posterior
tibial pulse
• leg and foot temperature signifi-
cantly lower when compared to
the contralateral limb
• Minimal or non-existent periph-
eral sensitivity of the toes below
the lesion
Confirmation of vascular injury by
Doppler ultrasound or angiography
or computed tomography.
Figure 2 – Medial approach for popliteal
supra-infra articular bypass
Figure 5 – Lateral and AP radiography
profile after closed reduction and fixa-
tion with external fixators
The percentage of diagnosed
vascular lesions with indication for
surgical treatment varies between
64-100%. 6,12,13 In patients with knee
dislocation and popliteal disrup-
tion, the primary objective is to
revascularize the limb, which must
be performed within 4 to 6 hours,
preferably through contralateral
venous crossover bypass, due to the
probability of associated ipsilateral
v