ORTHOPAEDICS - ADULT
KNEE DISLOCATION
Prompt
ResponseRight ANTERIOR knee dislocation
PromptHigh risk structures in knee dislocation
ResponsePopliteal artery ~30%
Nerve damage ~30% (common peroneal more common than tibial)
Ligamentous - Cruciates, medial colateral
Compartment syndrome
Long term:
Arthrofibrosis
Joint instability/laxity
DVT
Chronic pain
Nerve damage ~30% (common peroneal more common than tibial)
Ligamentous - Cruciates, medial colateral
Compartment syndrome
Long term:
Arthrofibrosis
Joint instability/laxity
DVT
Chronic pain
PromptManagement priorities
ResponseAnalgesia (IV fenatnyl 25-50 mic aliquots titrate to comfort)
Procedural sedation (Ketamine/propofol) to facilitate urgent reduction of the knee joint in ED
CT angiogram to ascertain vascular insult
Urgent orthopaedic referral
Procedural sedation (Ketamine/propofol) to facilitate urgent reduction of the knee joint in ED
- Informed consent
- Sedation
- Joint realignment by longitudinal traction
- Immobilise in long leg posterior splint with knee in partial flexion
CT angiogram to ascertain vascular insult
Urgent orthopaedic referral