Knee dislocation: Difference between revisions

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#Reduce immediately
#Reduce immediately
##Apply longitudinal traction
##Apply longitudinal traction
#Splint in 20 degrees of flexion
##Splint in 20 degrees of flexion
#Arteriography?
#Vascular assessment
##Some recommend for all pts due to high incidence of popliteal artery injury (~33%)
##Assess popliteal and distal pulses
###Presence of normal distal pulses does not rule out injury
##Measure ABIs
##Some only recommend for pts w/ pulse deficit or abnormal ABIs
##Duplex ultrasound
#Ortho and vascular surgery consultation
#Disposition
#Admit
##Strong distal pulses + ABI >0.9 + normal UTZ = Admit for obs with ortho consult
###Otherwise, obtain vascular surgery consult and additonal study (e.g. arteriogram, CTA)


==Source==
==Source==
*Tintinalli
*Tintinalli
*UpToDate


[[Category:Ortho]]
[[Category:Ortho]]

Revision as of 20:06, 13 February 2012

Background

  • Spontaneous reduction occurs in up to 50% of dislocations
    • Suggestive by severely injured knee that is unstable in multiple directions
  • Types
    • Anterior (40%)
    • Posterior (33%)
    • Lateral (18%)
    • Medial (4%)

Management

  1. Reduce immediately
    1. Apply longitudinal traction
    2. Splint in 20 degrees of flexion
  2. Vascular assessment
    1. Assess popliteal and distal pulses
    2. Measure ABIs
    3. Duplex ultrasound
  3. Disposition
    1. Strong distal pulses + ABI >0.9 + normal UTZ = Admit for obs with ortho consult
      1. Otherwise, obtain vascular surgery consult and additonal study (e.g. arteriogram, CTA)

Source

  • Tintinalli
  • UpToDate