The popliteal artery gives sural branches to the medial and lateral heads of gastrocnemius and additional muscular branches to soleus and popliteus in the popliteal fossa before dividing into anterior and posterior tibial arteries. The sural arteries are the dominant popliteal fossa muscular branches.
The popliteal artery muscular branches must be identified and controlled during posterior knee approaches and total knee arthroplasty to prevent significant popliteal fossa haemorrhage. The medial sural artery is the basis for the medial gastrocnemius myocutaneous flap used for proximal tibial wound coverage after tibial fracture or implant infection. Popliteal artery injury in knee dislocation disrupts these branches along with the main trunk.
Disruption of popliteal muscular branches and potentially the main popliteal trunk from high-energy knee dislocation producing ischaemia of the calf and foot, requiring urgent vascular assessment and repair.
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