Knee and Patellar Dislocations: Identifying Subtleties for Optimal Recognition and Management


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Abstract

Knee dislocations have the potential to result in significant morbidity and mortality if not correctly diagnosed and optimally managed. Early identification and treatment of neurovascular injury and compartment syndrome may avert disaster for the patient. Recognition of hard signs of vascular injury mandate immediate surgical exploration, whereas soft signs of vascular injury require further diagnostic evaluation. Closed reduction may be performed when emergency surgery is not indicated. Following reduction, hospital admission is recommended to monitor for neurovascular compromise.Patellar dislocations are common, and the vast majority are managed by the ED physician. Acute surgical management is uncommon and indicated for persistent patellar subluxation and detachment of the vastus medialis obliquus muscle and medical retinaculum from the medial aspect of the patella.The authors present a comprehensive and detailed review of the diagnosis and management of knee and patellar dislocations. Common pitfalls and diagnostic advances are reviewed and discussed to maximize patient outcome and decrease long-term functional morbidity.—The Editor

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