Knee dislocation

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. Neurologic assessment
   1. Peroneal nerve most commonly injured
      1. Test for sensation in 1st dorsal web space, dorsiflexion of foot, extension of toes
4. 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