Podcast 527: Knee Dislocations

<p><strong>Contributor</strong><strong>:  Erik Verzemnieks, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Knee dislocations are most common in high energy trauma, such as a motor vehicle accident</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">The knee may appear grossly normal on initial inspection since dislocations can spontaneously reduce - Look for such findings as hemarthrosis, instability, or ecchymosis, as clues to an occult dislocation. </span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Knee dislocations are often associated with damage to the popliteal artery that runs behind the knee. </span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Assess for pulse deficit on exam. If you are concerned - use the ankle-brachial index (normal >0.9). If the ABI is abnormal, evaluate with CT angiogram and a vascular surgery consult. </span></li> </ul> <p> </p> <p><strong>References</strong></p> <p><span style="font-weight: 400; font-size: 10pt;">Mills WJ, Barei DP, McNair P. The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma. 2004 Jun;56(6):1261-5.</span></p> <p><span style="font-weight: 400; font-size: 10pt;">Steele HL, Singh A. Vascular injury after occult knee dislocation presenting as compartment syndrome. J Emerg Med 2012; 42:271.</span></p> <p><span style="font-weight: 400; font-size: 10pt;">Sillanpää PJ, Kannus P, Niemi ST, et al. Incidence of knee dislocation and concomitant vascular injury requiring surgery: a nationwide study. J Trauma Acute Care Surg 2014; 76:715.</span></p> <p><span style="font-weight: 400; font-size: 10pt;">Summarized and written by myself</span></p> <p><br /> <br /></p>