Abstract
Children with an injured peripheral artery should undergo surgical reconstruction to prevent limb shortening if possible. We report the case of a child with initially ineffective treatment of an injured popliteal artery associated with blunt trauma. A 10-year-old boy received a hard kick on the knee while practicing karate. Three days later, he experienced intermittent claudication in his left lower extremity on exercise and was transported to our hospital. A computed tomographic angiogram of the left popliteal artery revealed 50% stenosis, and therefore we started medical therapy. After 1 month, he experienced pain and discomfort in his left lower extremity at rest and was admitted. Angiography revealed total occlusion of his left popliteal artery, the distal part of which developed collateral circulation. We immediately performed percutaneous transluminal angioplasty on the left popliteal artery. However, his symptoms did not improve, and ultrasonography showed that the obstruction in the left popliteal artery was caused by a thrombus. Despite undergoing a thrombectomy, his symptoms did not improve. Finally, we performed interposition with a reversed saphenous vein graft, with excellent postoperative outcome. Vascular injuries resulting from blunt trauma are rare in children, and the importance of ensuring normal limb growth patterns should be considered in the selection of surgical treatment.
