Knee dislocation: Difference between revisions
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==Background== | ==Background== | ||
*Popliteal artery injury occurs in ~25% of cases | |||
*Spontaneous reduction occurs in up to 50% of dislocations | *Spontaneous reduction occurs in up to 50% of dislocations | ||
**Suggestive by severely injured knee that is unstable in multiple directions | **Suggestive by severely injured knee that is unstable in multiple directions | ||
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##Peroneal nerve most commonly injured | ##Peroneal nerve most commonly injured | ||
###Test for sensation in 1st dorsal web space, dorsiflexion of foot, extension of toes | ###Test for sensation in 1st dorsal web space, dorsiflexion of foot, extension of toes | ||
==Disposition== | |||
#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== | ||
Revision as of 18:42, 26 August 2012
Background
- Popliteal artery injury occurs in ~25% of cases
- 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
- Reduce immediately
- Apply longitudinal traction
- Splint in 20 degrees of flexion
- Vascular assessment
- Assess popliteal and distal pulses
- Measure ABIs
- Duplex ultrasound
- Neurologic assessment
- Peroneal nerve most commonly injured
- Test for sensation in 1st dorsal web space, dorsiflexion of foot, extension of toes
- Peroneal nerve most commonly injured
Disposition
- 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
- Tintinalli
- UpToDate