This gentleman developed popliteal artery thrombosis after a closed knee dislocation and closed reduction. A segment of the subscapular arterial system was used to provide a small, tapering, branched arterial graft.
The calf fasciotomy site was progressively closed with a heavy prolene suture tightened with a banjo string tuning peg anchored to the patient's cast. |
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Subscapular artery graft harvest |
The subscapular graft |
Branched reconstruction of popliteal pranches to anterior and posterior tibial arteries. |
Fasciotomy wound: initial attempts at progressive closure with staples and vessel loops were thwarted by repeated breaking of the elastics (below). |
After the patient had healed enough for casting, the wound was progressively closed with a running intradermal prolene attached to a banjo tuning peg which was tightened over the course of days. |
Final closure at the bedside with staples |
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