Nai artery injury

　　1. Etiology

　　The injury of the femoral condyle fracture, strong violence causing patellar dislocation, comminuted fractures of the condyle, and sharp instrument injuries can all cause injury.

　　2. Pathogenesis

　　The Nai artery originates from the inferior margin of the adductor canal and continues with the femoral (superficial) artery, descending to a point 5 to 8 cm below the tibial plateau, and then divides into the anterior tibial artery and the tibiofibular trunk. Since the Nai artery is closely attached to the superior surface of the femoral condyle, it is a common clinical problem that during the occurrence of femoral condyle fractures, the posterior part of the gastrocnemius muscle contracts, causing the distal end of the fracture to displace posteriorly, leading to injury of the Nai artery. In addition, traumatic patellar dislocation, comminuted fractures of the condyle, and blunt trauma to the popliteal fossa are also common causes. One should also be vigilant about iatrogenic factors, especially the possibility of injury during the treatment of femoral condyle fractures, which is not uncommon in clinical practice.

　　Pay attention to the occurrence of compartment syndrome of the lower leg muscle interval. After the limb is crushed or affected by other causes mentioned above, the muscle bleeding and swelling in the fascial interval increase the volume of the contents in the interval. Due to the constraint of the osseofascial sheath, it cannot expand outward, resulting in increased pressure in the interval. The increased pressure increases the resistance of lymph and venous return in the interval, leading to increased venous pressure, and further increases the pressure in the capillaries, thereby increasing the exudation and further increasing the volume of the contents in the interval, making the pressure in the interval further increase, forming a vicious cycle. Once it occurs, timely diagnosis and treatment are needed.

　　The clinical symptoms are similar to those with involvement of the femoral artery, mainly manifested by ischemia below the calf and weakened (or disappeared) dorsalis pedis artery pulse; if it is caused by supracondylar fracture, it has the characteristic signs of the fracture, including deformity of the lower end of the thigh, elastic fixation, severe pain, and limited activity. When the lower leg has severe insufficient blood supply, ischemic peripheral neuritis may occur, with symptoms such as pain, hypersensitivity, and numbness.

　　The sooner the better, as the timing of diagnosis is closely related to the prognosis, and there is no room for any hesitation. Arterial injury generally has a low difficulty in diagnosis, especially when there is progressive hematoma at the Na窝, which gradually worsens and is synchronous with the pulse, indicating that it is due to arterial injury; of course, if there is fresh blood (or spurting) at the incision along the course of the artery, it is easier to make a diagnosis. In addition, it can also be determined from the disappearance (or weakening) of the dorsalis pedis artery pulse, the degree and direction of displacement of the femoral condyle or fracture, and other aspects. For those with difficult diagnosis, or in order to determine pseudo-aneurysm and arteriovenous fistula, arterial angiography can also be performed, which is easier to operate and can be directly completed by puncturing the femoral artery from the mouse's ear.

　　1. Go to bed early and get up early, exercise the body. Insufficient sleep can reduce the body's immune function and is also prone to irritability and internal injury.

　　2. Maintain a peaceful mind. It is taboo to be angry in spring, and do not be too impulsive in dealing with things. Always maintain a peaceful mind.

　　3. Quit smoking, reduce alcohol and coffee intake. Smoking is most likely to damage the surface barrier of the respiratory tract, triggering disease attacks. Alcohol, tobacco, and coffee can stimulate nerve excitement, and some people may think they can 'relieve tension and fatigue' by doing so, but in fact, they weaken the body's ability to resist diseases.

　　Arterial angiography can be performed when necessary, which is a method of imaging the arterial system by directly injecting contrast agent into the artery (either manually or with a high-pressure syringe) to fill the artery with contrast agent. The distribution, number, and morphology of the human arterial system are relatively constant, and angiography examination is mainly arterial angiography. Angiography plays an important role in the diagnosis and treatment of diseases of the head and neck, central nervous system, cardiovascular diseases, and tumors and peripheral vascular diseases.

　　I. Dietotherapy for Arterial Injury

　　1. Yam noodles

　　Ingredients: 150 grams of yam powder, 300 grams of flour, 1 egg, 20 grams of bean powder, and appropriate seasoning.

　　制法：将山药、面粉、豆粉、鸡蛋及清水、食盐适量放入盆内，揉成面团，制成面条。锅内放清水适量，武火煮沸后放面条、猪油、葱、姜，煮熟后再放味精适量服食。

　　Preparation: Put yam, flour, bean powder, eggs, and an appropriate amount of water and salt in a bowl, knead into dough, and make noodles. Put an appropriate amount of water in the pot, boil it with high heat, add noodles, lard, scallions, and ginger, cook until done, and then add an appropriate amount of monosodium glutamate to serve.

　　2. Salvia and Ophiopogon Tea

　　Ingredients: Salvia miltiorrhiza 10g, Ophiopogon japonicus 10g.

　　Preparation: Boil with hot water and drink as tea.

　　3. Asparagus and Winter Melon Soup

　　Ingredients: Asparagus 250g, winter melon 300g.

　　Preparation: Add salt, monosodium glutamate, and other seasonings to the two ingredients, boil the soup and eat it.

　　II. What Foods Are Good for Popliteal Artery Injury Patients

　　1. Eat more foods rich in vitamin C, such as kiwi and orange.

　　2. It is advisable to eat more fresh fruits and vegetables.

　　III. What Foods Are Bad for Popliteal Artery Injury Patients

　　1. Abstain from alcohol and smoking.

　　2. Do not eat fried and baked foods.

　　Conventional methods of Western medicine for treating popliteal artery injury

　　I. Treatment

　　1. Patients with clear diagnoses should undergo popliteal artery repair and reconstruction immediately, including cases confirmed by angiography, which should all be treated as emergencies to minimize the time of limb ischemia.

　　2. Patients suspected of having an arterial injury should undergo surgical exploration early, especially for those who need surgical treatment for fractures, and more time should be争取 in order to perform fracture reduction and internal fixation surgery under the premise of prioritizing the exploration and repair of the popliteal artery.

　　3. Eliminating the causative factors mainly refers to bone and joint injuries near the course of the popliteal artery, which must strive for good reduction and stable and effective internal fixation. This is not only a requirement for the treatment of popliteal artery injury but also the primary condition for preventing re-injury.

　　4. Patients with venous injury should be repaired simultaneously to prevent secondary muscle interval hypertension syndrome due to increased peripheral resistance.

　　II. Prognosis

　　After vascular anastomosis, blood circulation is restored, and the prognosis is generally good.