2.  37 yo female p/w knee
pain s/p front-end MVC
as a restrained passenger
with the left knee striking
the dashboard. Pt cannot
move knee secondary to
pain. No other injuries
noted.
 T 98.7 P 103 BP 117/62 O2





100%
Gen:
CV: Tachycardic, RR, no
m/r/g
Pulm: Lungs CTA bilat
GU: nml
Ext: Left knee grossly
unstable and unable to
extended. Decreased
sensation over lateral
foot.

5.  25% knee dislocations
 Both Cruciate Ligament disruption (ACL & PCL)
 Popliteal artery injury
 Behind the lateral meniscus, posterior to Tibial Plateau
 Less common than anterior dislocation as extensor
mechanisms provide protection from anterior
 Nerve Injury (16-40%)
 Tibial and Fibular nerve 2/2 traction

6.  Reduction with traction/ countertraction
 Avoid compression in the popliteal space
 Immobilization
 Long-Leg post splint in 15 degrees flexion (less tension
popliteal a.)

7.  Assessment of Vascular Injury
 Perform ABI vs CT Angio of lower extremity given high
risk of popliteal artery injury
 If injury present  Emergent Vascular Surgery c/s
 Emergent Orthopedic referral
 Admit for vascular rechecks  compartment syndrome
 Likely operative repair 10-14 days with decreased
swelling

8.  http://www.imageinterpretation.co.uk/pelvis.html
 http://www.wheelessonline.com/ortho/12846
 Redmond, Levy, Dajani, et al. Detecting Vascular Injury in
Lower-Extremity Orthopedic Trauma: The Role of CT
Angiography. ORTHOPEDICS. August 2008;31(8):761.
 http://www.wheelessonline.com/ortho/traumatic_dislocat
ions_of_the_knee
 http://reference.medscape.com/features/slideshow/lwrdisloc
 http://www.accessemergencymedicine.com/overflow.aspx?
searchStr=dislocations&hasExactMatch=True&hasDrugMa
tch=False&searchSource=Images&ftbool=False