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