Podcast 722: Lower Extremity Dislocations

<p><strong>Contributor: Donald Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Hip Dislocation</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Prolonged dislocations can impair blood supply to femoral head</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Hip dislocation for >6 hours puts patient at high risk for needing a hip replacement in the next two year</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Knee Dislocation</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">High mechanism</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Often looks anatomically normal on knee x-ray</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Vascular injuries of the popliteal artery can cause significant morbidity with some studies suggesting an 80% amputation rate if not treated within 6 hours</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Ankle Dislocation</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Common dislocation and often co-occurs with ankle fractures (bimalleolar/trimalleolar)</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Pressure on the skin from the displaced joint can cause skin tenting, which can lead to skin necrosis</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Hematoma blocks work well for ankle reductions as an adjunct to or substitute for procedural sedation</span></li> </ul> </li> </ul> <p><strong>References</stron