On rupture of the popliteal artery and popliteal aneurism / by Alfred Poland.

  • Poland, Alfred, 1822-1872.
Date:
[1860?]
Catalogue details

Licence: Public Domain Mark

Credit: On rupture of the popliteal artery and popliteal aneurism / by Alfred Poland. Source: Wellcome Collection.

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    where the head of the tibia is thrown backwards from off the condyles, tearing through the vessels and appearing at the external wound. Such instances are frequently recorded. In these cases the ruptured vessel is at once apparent, and the nature of the injury such as to require immediate amputation; and it is a remarkable fact, how often there is so little or even no hsemorrhage after the first gush of blood has issued from the wound; the forcible laceration of the vessel, so highly favorable to the plugging of the torn ends, is almost immedi¬ ately succeeded by coagulation, and in a few hours is of such firmness and solidity as to allow of much manipulation and movement^ without disturbance. This w'as well exemplified in a case that was brought to Guy's Hospital many years ago. The man had fallen down a well, and one of his legs, during the descent, having been caught at the edge of the well, was forcibly doubled up, bending the knee in the contrary direc¬ tion, so that the toes touched the bend of the thigh. \ The condyles of the femur protruded through a large wound in the popliteal space, and he lost some blood. In this condition he was sent to the hospital in a very shaky vehicle, and arrived about three hours after the accident. On admission, the rup¬ tured ends of the popliteal vessels were lying exposed in a large wound in the popliteal space; no ligature had been ap¬ plied, and no hsemorrhage had taken place during the journey. The ends of the vessels were firmly plugged with coagulum, and the upper end of the artery could be observed pulsating most vigorously and forcibly, and yet completely under the com¬ mand of the plug. There was also a fracture of the thigh in its upper third on the same side; short splints were applied to steady this fracture, and the limb amputated at the junction of the middle with the lower third. A good recovery w^ made, and the fracture united firmly. Not only in compound dislocations, but in other severe in juries about the knee, is the artery torn through and without haemorrhage. In these cases, like the preceding, the injury is at once perceived, and amputation, as the only resource, per¬ formed; thus the following cases are examples of this circum¬ stance : A patient was brought into Guy’s Hospital with a compound fracture of the leg, extending close to the knee-joint; amputation was performed above the knee.