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Use of a hinged external knee fixator after surgery for knee dislocation
James P Stannard1, Todd M Sheils, Gerald McGwin
1Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-3295, USA. James.Stannard@ortho.uab.edu
Summary
The compass knee hinge (CKH) external fixator may improve outcomes for knee dislocations after blunt trauma. This device allows for aggressive physical therapy, potentially reducing ligament repair failures compared to standard external braces.
Area of Science:
- Orthopedic surgery
- Trauma care
- Biomedical engineering
Background:
- Knee dislocations following blunt trauma present complex challenges in treatment.
- Effective management requires balancing ligamentous stability with early mobilization.
Purpose of the Study:
- To document short-term clinical outcomes of knee dislocations after blunt trauma.
- To evaluate the efficacy of the compass knee hinge (CKH) external fixator in treating these injuries.
Main Methods:
- A nonrandomized prospective functional outcome study was conducted.
- Forty patients with 43 knee dislocations were divided into two groups: Group A (CKH with ligament reconstruction) and Group B (external brace with ligament reconstruction).
Main Results:
- Group A (CKH) showed significantly lower ligament procedure failure rates (7%) compared to Group B (29%, P <.05).
- Specific ligament reconstructions, including anterior cruciate ligament (ACL) and posterolateral corner (PLC) repairs, demonstrated improved success rates with the CKH.
- SF-36 scores indicated low functional outcomes in both groups, with no significant difference between them.
Conclusions:
- Aggressive surgical treatment and physical therapy are crucial for knee dislocations post-blunt trauma.
- The CKH external fixator appears to facilitate safe, aggressive physical therapy, potentially reducing ligament failure rates in the short term.