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Updated: May 11, 2025
#Popliteal Aneurysm.# This is the most common surgical aneurysm, and is not infrequently met with in both limbs. It is generally due to disease of the artery, and repeated slight strains, which are so liable to occur at the knee, play an important part in its formation. In former times it was common in post-boys, from the repeated flexion and extension of the knee in riding.
When a large arterial trunk, such as the external iliac, the femoral, the common carotid, the brachial, or the popliteal, has been partly divided, for example, in the course of an operation, the opening should be closed with sutures arteriorrhaphy.
Displacement or partial extrusion of the dead bone may cause complications, as when a sequestrum derived from the trigone of the femur perforates the popliteal artery or the cavity of the knee-joint, or a sequestrum of the pelvis perforates the wall of the urinary bladder.
An instantaneous gush of blood took place, and I realized that I had unexpectedly severed the popliteal artery, before Voigtman, who was tying the veins, was ready to deal with it. I endeavoured to staunch the deadly flow by nipping the vein between my thumb and forefinger, whilst Voigtman hastily tried to tie it.
The sac may press upon the popliteal artery or vein and their branches, causing congestion and œdema of the leg, and lead to gangrene. Pressure on the tibial and common peroneal nerves gives rise to severe pain, muscular cramp, and weakness of the leg.
#Subcutaneous rupture# of veins occur most frequently in association with fractures and in the reduction of dislocations. The veins most commonly ruptured are the popliteal, the axillary, the femoral, and the subclavian.
When an embolus becomes impacted at the bifurcation of the popliteal, if gangrene ensues it usually spreads well up the leg. When the axillary artery is the seat of embolic impaction, and gangrene ensues, the process usually reaches the middle of the upper arm.
Frequently a large branch establishes a communication between the systems of the great and small saphenous veins in the region of the popliteal space, or across the front of the upper part of the tibia. The superficial position of this last branch and its proximity to the bone render it liable to injury.
The separated epiphysis may be kept in place by the periosteum, but when this has been detached by the formation of pus beneath it, the epiphysis is liable to be displaced by muscular action or by some movement of the limb, or it is the diaphysis that is displaced, for example, the lower end of the diaphysis of the femur may be projected into the popliteal space.
Experience shows that ligation of the vein, or even the removal of a portion of it, is not necessarily followed by gangrene. The risk of gangrene is diminished by a course of digital compression of the femoral artery, before operating on the aneurysm. Aneurysmal varix is sometimes met with in the region of the popliteal space.
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