Hinged External Fixators Protect Ligament Reconstructions in Knee Dislocations

Abstract

Knee dislocations occur as the result of high-energy trauma. These devastating knee injuries have been addressed with a myriad of surgical approaches, and treatment has evolved from primary repair to reconstruction of torn ligaments. Early surgery has shown benefit over delayed surgery1. Cast immobilization has given way to early rehabilitation; however, stiffness remains the greatest obstacle to successful knee function. Balancing the risk of stiffness with the need for a stable environment to encourage healing of multiple ligament reconstructions is a challenge and the impetus for this investigation by Stannard et al. This study is a prospective randomized controlled trial on the use of a hinged external fixator as an augment to a staged reconstruction protocol. Patients either received a hinged external fixator that was placed during the posterior cruciate ligament (PCL), posterolateral corner, or posteromedial corner reconstruction …