Abstract
Knee dislocation is a devastating injury that can compromise the limb's viability. This trauma is associated with muscular and ligamentar extensive lesions. Obese patients can suffer of knee dislocation resultant from falls at the same level, and these “super-low” energy dislocations are associated with a surprising rate of neurovascular complications. The popliteal artery may be involved in up to 60% of cases, and the prognosis is considerably worse. In these cases an emergent approach is mandatory. Delayed diagnosis and treatment can result in up to 80% of amputations of the extremity. The authors present a patient that was admitted at the Emergency Room with knee pain and deformity after a fall at the same high. After the diagnose and reduction of the anterior dislocation, an echo-doppler and CT angiography were performed, and revealed a lesion in popliteal artery. After immobilized with a long leg plaster cast, the patient was transferred to a hospital with Vascular Surgery Department, and underwent revascularization of the limb. Despite the severity of the vascular injury the patient had a very good outcome.
Highlights
Knee dislocation is a relatively rare injury
Obese patients can suffer of knee dislocation resultant from falls at the same level, and these “super-low” energy dislocations are associated with a surprising rate of neurovascular complications
In obese patients, they can result from falls at the same level, and these “super-low” energy dislocations are associated with a surprising rate of neurovascular complications. [3, 4] The popliteal artery may be involved in up to 60% of cases
Summary
Knee dislocation is a relatively rare injury. The extensive lesion of soft tissues and the high incidence of neurological and mainly vascular complications, associated to this event, can compromise the limb's viability. [1, 2] Knee dislocations are usually related to high-energy trauma, being associated with multiple injuries, namely ligaments, meniscal, neurovascular and fractures. A 59-year-old female patient was admitted at the Emergency Room after a fall at the same high on the sidewalk As relevant comorbities, she had BMI = 43 kg/m2, dyslipidemia and hypertension. Distal pulses were palpable but diminished on the affected side.The radiographs (Figure 1) confirmed the anterior dislocation of the knee with no associated fractures. She was immediately submitted to closed reduction of the dislocation under sedation and immobilized with a posterior long leg splint. At 6 months of follow-up, she had an occasional mechanical left knee pain, associated with a feeling of knee instability that did not limit her activities of daily living She walked without gait support and had knee mobility of 0-120 degrees.
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