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At least 325 records · Page 18Linked to original sources
PubMed1997

Femoral-sided fracture-dislocation of the knee.

OBJECTIVE: To document a previously undescribed fracture-dislocation of the knee that involves a femoral condyle and associated ligaments yet spares the tibial joint surface. DESIGN: Retrospective. SETTING: University. PATIENTS: Four cases of fracture-dislocation of the knee that involve ligamentous injury and fracture of the femoral condyle(s). RESULTS: At a minimum two-year follow-up (average 28.8 months, range 26 to 37 months), overall functional outcome is only fair to good in this injury pattern. The Lysholm knee rating averaged 60 (range 39 to 74) and KT-1000 I-N testing averaged three millimeters at thirty pounds. CONCLUSION: Despite treatment of this fracture-dislocation with internal fixation of the femoral condyle(s) and repair of the ligament(s), functional deficits occur in this severe knee injury patterns.

Adult↗
PubMed2005

Treatment of acute and chronic anterior cruciate ligament-posterior cruciate ligament-lateral side knee injuries.

Knee dislocations are rare but devastating injuries. The ACL-PCL-lateral side injury combination is representative of the challenges these injuries present. Early management is focused on vascular integrity. When possible, acute repair and reconstruction within 3 weeks from injury is preferred. Chronically deficient knees generally will require lateral side reconstruction rather than repair and may require limb realignment. Addressing all injured structures is imperative to afford the best chance at a reasonable outcome. Good results with surgery are possible, but some degree of persistent disability is to be expected.

Anterior Cruciate Ligament↗
PubMed2005

Peroneal nerve palsy associated with knee luxation: evaluation by sonography--initial experiences.

OBJECTIVE: Traumatic knee dislocation needs immediate surgical repair to restore joint function. A concomitant traction injury of the peroneal nerve is reported to exist in up to 25% of cases and is often overlooked initially. In patients with major nerve lesions, immediate surgical nerve repair might be necessary to avoid irreversible loss of neural function. In the present study, we tried to evaluate whether sonography is a valuable tool for identification of nerve pathology that warrants surgical intervention. SUBJECTS AND METHODS: In this prospective study, both peroneal nerves in nine patients with one-sided peroneal nerve palsy after closed knee luxation and the peroneal nerves of 11 healthy volunteers were investigated with sonography. Using statistical analysis, we tried to define the comparability and significance of the findings. RESULTS: The mean cross-sectional area of healthy peroneal nerves in the genicular region was 0.18 cm2 (SD, 0.07 cm2). Impaired nerves were significantly discerned because of their increased cross-sectional area at the level of the injury (mean cross-sectional area, 0.7 cm2; SD, 0.46 cm2; p < 0.05). Identification of caliber changes and depiction of at least one nerve stump were found to be the most specific criteria for the definition of a major neural lesion. The ability of sonography to provide additional information about surrounding soft-tissue impairment (scar tissue and hematoma formation) proved helpful. CONCLUSION: Sonography allows radiologists to visualize neural and extraneural pathology and to define the exact level and extent of lesions. Thus, it may be a valuable adjunct in the decision of whether surgical intervention is necessary.

Adolescent↗
PubMed1984

Stability and motion after traumatic dislocation of the knee.

In a series of 10 patients with traumatic dislocation of the knee joint, closed reduction could be accomplished in nine. Conservative treatment was employed in four and operative repair of the ligaments and capsule in six patients. In two of three patients with complicating artery injury, vascular repair was successful. Above-knee amputation was performed in one patient because of delay in the diagnosis of vascular injury and in another patient because of arteriosclerotic gangrene. At follow-up examination, on average 6 years after the accident, the stability and motion of the knee were evaluated as good in five patients (three operated), fair in two (one operated) and as poor in one operated patient. The conclusions are that good knee function can thus be achieved with both conservative and operative treatment, and that limb salvage depends on prompt diagnosis and treatment of vascular complications.

Adolescent↗
PubMed1979

Larsen's syndrome. Case report and discussion.

The writers present the case of a small girl affected by Larsen's syndrome. Her brother had the same syndrome. Surgical reduction of the dislocated knees was performed at the age of two months, followed by immobilisation in a spica plaster. At operation it was found that both patellae, which are cartilaginous at that age, were absent. On the basis of recent literature and the heterogeneous manifestations of the syndrome, the authors discuss the pathogenetic theories, the differential diagnosis, and the current therapeutic possibilities.

Abnormalities, Multiple↗
PubMed1998

Spontaneous popliteal vascular injury in the morbidly obese.

PURPOSE: Morbidly obese patients who sustained popliteal vascular injury after spontaneous knee dislocation (KD) were studied. METHODS: Seven morbidly obese patients (body mass index [BMI] >35 kg/m2 and >100 lb over ideal body weight) who sustained spontaneous KD while upright were reviewed. RESULTS: Severe popliteal arterial injury accompanied all spontaneous KD. The mean age of patients was 34.1 +/- 6.7 years; the mean weight was 354 +/- 150 lb (range, 220-702 lb); and mean BMI was 53 +/- 21 kg/m2 (range, 37-98.4). All had arterial avulsion and thrombosis. Three had concomitant venous injury. All underwent operative repair. Morbid obesity presented unique challenges to surgical management. Limited positioning, specialized operative tables, large incisions, deep exposure, special retraction, long operative times (mean, 537 +/- 134 minutes), and major blood loss (mean, 2.5 +/- 3 L) were standard. Five arterial injuries were repaired with interposition vein grafts, and 2 required tibial bypass. Venous repairs included thrombectomy and primary repair (n = 2) and interposition grafting (n = 1). Many complications were related to morbid obesity, including deep wound infection (n = 3), diabetic ketoacidosis (n = 2), and cor pulmonale from sleep apnea (n = 1). Despite patent grafts in all patients, 2 above-knee amputations were required for extensive neuromuscular loss. CONCLUSION: Morbid obesity is a specific risk factor for spontaneous KD and vascular injury. In addition, morbid obesity presents unique challenges to operative repair and predisposes patients to unusual major postoperative complications.

Adult↗
PubMed2006

Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear.

We report two cases of marginal fractures of the medial tibial plateau associated with medial meniscal root tears. Both patients sustained knee dislocations, with complete tears of the posterior horn medial meniscal root. One sustained a "reverse Segond fracture"; the other sustained an "anteromedial impingement fracture" of the tibial plateau. The meniscal root tears were arthroscopically confirmed and repaired. In the first patient, the integrity of the meniscal root repair was confirmed at a 6-month follow-up arthroscopy for lysis of adhesions. In the second patient, follow-up MRI at 10 months demonstrated a healed meniscal root. The association of medial meniscal root tear with marginal fractures of the medial tibial plateau has not been previously reported.

Adolescent↗