Aplastic Posterior Tibial Artery in the Presence of Trimalleolar Ankle Fracture Dislocation Resulting in Below-the-Knee Amputation.
Publication Title
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
Document Type
Article
Publication Date
1-1-2017
Keywords
Aged, 80 and over; Amputation; Ankle Fractures; Arterial Occlusive Diseases; Emergency Service, Hospital; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Injury Severity Score; Joint Dislocations; Lower Extremity; Magnetic Resonance Angiography; Popliteal Artery; Postoperative Complications; Rare Diseases; Tibia; Tibial Arteries; Tomography, X-Ray Computed; Treatment Outcome
Abstract
We present an interesting, but unfortunate, case of an 86-year-old female who sustained a trimalleolar ankle fracture dislocation that resulted in below-the-knee amputation after open reduction and internal fixation of the fracture. To the best of our knowledge, this is the first case report describing popliteal variants that ultimately resulted in critical limb ischemia and below-the-knee amputation after foot and ankle trauma. The anatomic variation altered the expected outcome from a relatively straightforward surgical case. We introduce the previously described lower extremity Allen test and describe how it can be a useful adjunct in the initial physical examination of lower extremity trauma. The ability to identify abnormal distal perfusion to the foot could provide enough insight to warrant evaluating the patient with angiography or computed tomography angiography.
Clinical Institute
Orthopedics & Sports Medicine
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Orthopedics
Specialty/Research Institute
Surgery
