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Emergency department evaluation and treatment of knee and leg injuries.

The knee is one of the most commonly injured joints in the human body, and, largely because of athletic injuries, they are increasing in frequency in the United States. This article provides a brief overview of knee anatomy, examines radiographic imaging techniques and arthrocentesis of the knee, and discusses injuries specific to the knee. An overview of leg anatomy is also presented, along with discussions of specific fractures common to the leg.

Anterior Cruciate Ligament Injuries↗

[Treatment of complex loss of substance in acute leg injuries].

Solving the problems inherent in the treatment of Gustillo type III open fractures of leg requires the intervention of multiple surgical disciplines: orthopedic, plastic and vascular. Consensus exists with respect to many therapeutic principles, but several points remain the subject of debate. Based on an extensive literature review, the indications, results and prognosis for both skin covery and bone reconstruction are defined as precisely as possible. Early treatment is essential, the loss of soft tissue substance being repaired within the first two weeks, particularly if the use of a free flap is envisaged. Two stage treatment, cutaneous and bony, offers the advantage of safety, with additional benefits if conventional grafts are applied within 1 to 2 months. Overall therapeutic results are dependent on good interdisciplinary team work and, to an increasing extent, on the urgent participation of plastic surgeons experienced in microsurgical techniques.

Acute Disease↗

Repair of lower leg injuries with fascio-cutaneous flaps.

Experience with sixteen consecutive cases of lower leg skin loss has confirmed the reliability of Pontén's fascio-cutaneous or "super flap" (1981) in the management of these difficult injuries. The technique has several important advantages compared with the conventional lower leg flaps of both the ipsi-lateral and cross-leg variety.

Fascia↗