Ipsilateral Knee Dislocation and Ankle Fracture Dislocation

A dislocated knee is a potential limb-threatening injury. Simultaneous dislocation of knee and ankle joint in an ipsilateral limb is a very rare pattern of injury. A few cases of ipsilateral hip and knee dislocation were described in literature. Rare injury such as posterior dislocation knee with ipsilateral ankle fracture dislocation cases was also presented. However, lateral dislocation of knee along with the same side ankle fracture dislocation is a rare scenario. To the best of our knowledge, these two simultaneous lesions do not seem to have been reported previously. Immediate management of such injury is to reduce both joint and stabilization with external fixator and definitive surgery in the second stage when soft-tissue condition allows.

We describe a rare case of a 37-year-old farmer having injury to his right leg with tiller machine. Lateral right knee dislocation and right ankle fracture dislocation reduced in the emergency department. In emergency OT, external fixator applied for knee and ankle stabilization. When swelling subsides in ankle, fracture fixation is done with plates and screws. Knee fixator is kept for 6 weeks then knee physiotherapy started.

Dislocation of any joint is treated as an orthopedic emergency. Simultaneous dislocation of knee and ankle joints in an ipsilateral limb is a challenging situation for even the experienced surgeon. The outcome of such patients varies with associated injuries and time took for relocation and meticulous physical examination, with a high index of clinical suspicion is needed in diagnosing and management of such cases.