Popliteal artery injuries are frequently seen with fractures, dislocations, or penetrating injuries. Concern about arterial injury and early recognition of the possibility of arterial injury is crucial for the salvage of the extremity. This article provides an outline of the diagnostic challenges related to these rare vascular injuries and emphasizes the necessity for a high level of suspicion, even in the absence of a significant penetrating injury, knee dislocation, fracture, or high-velocity trauma mechanism. The importance of a detailed vascular examination of a blunt trauma patient is emphasized. Popliteal artery injury is mainly associated with high energy injury, including knee dislocation and complex tibia plateau fractures or supracondylar femur fractures. Delay in its diagnosis is the leading cause of amputation in this limb-threatening injury. Failure to vascularize within 6–8 hours results in an unacceptably high amputation rate. Blunt trauma to the lower extremity has been associated with a 28% to 46% rate of injury to the popliteal artery in the form of transection, occlusion, laceration, perforation, arteriovenous fistula, or intimal injury.1–3 The popliteal artery, by virtue of its ligamentous fixation and anatomic relationships to the femur, tibial plateau, and knee joint apparatus, is uniquely susceptible to injury with blunt extremity trauma.1,4 This arterial injury is frequently associated with knee dislocation following blunt trauma, and is seen with increasing frequency
