BACKGROUND: There are few data regarding limb salvage following below-the-knee (BK) arterial @entity130 . Based on published data and clinical experience, we hypothesized that any single patent vessel BK would allow for limb viability and salvage. METHODS: The @entity130 center registry was retrospectively queried, from 2007 through 2012, for @entity1 presenting with BK @entity1317 (BKAIs), defined as injury below the popliteal artery. Logistic regression, Pearson's   , and Student's t test were used to analyze data. RESULTS: A total of 122 @entity1 were identified. The mean age was 35 years, 84% were male, and 43% were non-white. Of the @entity1 , 83 (68%) sustained blunt and 39 (32%) sustained penetrating @entity130 . Fifty-one (41%) had an injury to a single BK vessel, and 12 (23.5%) of these underwent attempted repair. All seven @entity1 with two-vessel, and one of two @entity1 with three-vessel BKAIs had attempted repair. No @entity1 had endovascular repair. Amputation was not associated with Injury Severity Score (ISS), sex, or age. @entity1 with @entity1913 had higher amputation rates than those with @entity2982 (26.8% vs. 7.5%, p = 0.01). Of 51 @entity1 , 9 (17.6%) with a single BK vessel injury required amputation; when either two or three vessels were injured, amputation rates were 29% and 50%, respectively (p = 0.09). In @entity1 with @entity130 following blunt @entity130 , an injured @entity1347 ( @entity1347 ) was associated with a higher amputation rate (6 of 17 @entity1 , 35.3%) when compared with those @entity1 with either posterior tibial (PT) or peroneal (P) @entity130 (3 of 34 @entity1 , 8.8%, p = 0.045). The adjusted odds ratio of requiring an amputation after @entity1913 to the @entity1347 alone, compared with a PT or P injury, was 22.4 (p = 0.02). CONCLUSION: BKAIs are uncommon. In contrast to the commonly taught surgical dogma, which suggests that any intact single-vessel BK is associated with limb salvage, blunt @entity130 were associated with much higher rates of amputation when compared with P or PT @entity130 . Further studies should be undertaken to determine when repair BKAI should be attempted. LEVEL OF EVIDENCE: Epidemiologic study, level III.

Below-the-knee XXXX : The type of vessel may be more important than the number of vessels injured.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['anterior tibia', 'AT'] @entity2982 :: ('MESH:D020197', 'Disease') :: ['penetrating injury'] @entity1317 :: ('MESH:D057772', 'Disease') :: ['arterial injuries'] @entity1913 :: ('MESH:D014949', 'Disease') :: ['blunt injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['a single-vessel injury', 'AT vessel injuries', 'injuries', 'trauma']
@entity1317 :: (MESH:D057772,Disease) :: ['arterial injury']
