A single Bullet and two knees trauma : A very unusual mechanism leading to popliteal artery injury

Gunshot wounds are a significant cause of morbidity and mortality worldwide, often leading to severe clinical outcomes, especially when involving vascular injuries. This case report presents an unusual instance of a single gunshot resulting in bilateral knee injuries, causing a tibial plateau fracture in the right knee and a popliteal artery injury in the left knee. The 45-year-old male patient, with no prior medical history, sustained these injuries during a hunting trip. Initial assessment revealed functional impairment in both lower extremities and the absence of a pulse in the left leg, indicating potential vascular damage. Angiography confirmed a complete section of the left popliteal artery, necessitating immediate surgical intervention. The vascular team performed a bypass using the homolateral great saphenous vein, while the orthopedic team addressed the right knee fracture through debridement and immobilization. Post-surgery, the patient underwent an intensive rehabilitation program. At the two-year follow-up, he reported full functional recovery despite residual pain in the right knee. This case underscores the importance of rapid diagnosis, multidisciplinary treatment, and comprehensive rehabilitation in managing complex gunshot injuries. The successful outcome highlights the necessity for innovative strategies and collaboration among medical specialties to effectively address such rare and challenging cases.