Abstract
Popliteal artery injuries are known complications of distal femur fractures, often leading to life-threatening consequences. The authors present a case of a four-month-old missed popliteal artery injury complicating a nonunion of the distal femur. The patient, a 28-year-old male, initially sought alternative treatment after a bike accident but experienced persistent pain and functional limitations. During our clinical evaluation, the possibility of a popliteal artery injury was considered but not definitively ruled out. However, during surgery, an incomplete transection of the popliteal artery was discovered, posing life-threatening complications. Fortunately, through effective management, we were able to address the complications and proceed with the planned procedure. This case underscores the importance of recognizing vascular damage in delayed fracture presentations and highlights the necessity of a prompt, multidisciplinary approach to handle unexpected surgical complications. Insights gained from this case contribute to raising awareness and preparedness among healthcare providers in similar challenging scenarios.