Knee Dislocations

KNEE DISLOCATIONS
Classification
Anterior : knee hyperextension
Posterior : dashboard injury
Lateral : valgus force
Medial : varus force
Rotational : valgus/varus force with rotatory component
Mechanism of Injury
High-energy trauma : motor vehicle accidents
Low energy trauma : sports injury
Examination
Deformed knee joint with haemarthrosis
Exclude popliteal artery and lateral peroneal nerve injuries
X-rays
AP and lateral views of knee
Management
Immediate closed reduction of the knee joint is essential. Call Ortho Registrar.
IV pethidine and sedation with IV midazolam
Anterior dislocation : limb traction combined with lifting of the distal femur
Posterior dislocation : limb traction combined with lifting of the proximal tibia
Lateral dislocation : limb traction with detranslation of the tibia
Medial dislocation : limb traction with detranslation of the tibia
Rotatory dislocation : limb traction with derotation of the tibia
If unable to achieve reduction at the A&E, contact Ortho MO-on-call for assistance, KIV to prepare for M&R under GA.
Document neurovascular status before and after attempted reduction
Apply long backslab after successful reduction
Check X-rays are mandatory to confirm reduction
Admit all cases to Ortho Dept for monitoring of neurovascular status