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Irreducible Posterolateral Knee Dislocation: A Case Report.

Santiago Pache1, José María Vázquez1, Jorge Chahla2

  • 1Sanatorio Cantegril, Traumatología y Ortopedia, Punta del Este, Maldonado, Uruguay.

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|March 17, 2023
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Summary
This summary is machine-generated.

Irreducible knee dislocations require prompt diagnosis and open reduction to prevent soft-tissue damage. Early surgical intervention can lead to good functional recovery, even with some residual joint laxity.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Management

Background:

  • Posterolateral knee dislocations are severe injuries that can lead to neurovascular compromise and soft-tissue incarceration.
  • Irreducible dislocations, where the joint cannot be manually reduced, present a surgical emergency.

Observation:

  • A 62-year-old male experienced an irreducible posterolateral knee dislocation after a horse-riding accident.
  • Physical examination revealed a medial dimple sign, indicating incarceration of medial structures including the medial retinaculum, medial patellofemoral ligament, posteromedial corner, and vastus medialis obliquus (VMO) muscle within the joint.

Findings:

  • Open reduction was performed to release the incarcerated soft tissues.
  • The medial retinaculum and VMO were repaired, and the knee was stabilized with an external fixator for 4 weeks.
  • At 32-month follow-up, the patient achieved near-full knee range of motion and good subjective outcomes, with only moderate residual joint laxity.

Implications:

  • Early clinical diagnosis and emergent open reduction are crucial for irreducible knee dislocations to minimize soft-tissue compromise.
  • Prompt surgical management can restore function and improve patient outcomes in complex knee dislocations.
  • This case highlights the importance of timely intervention in preventing long-term complications associated with incarcerated knee dislocations.