Knieluxationen (Tibiofemoral)

Knee dislocations are frequently accompanied by arterial or nerve injuries. These dislocations can reposition spontaneously before the patient can be medically examined. Diagnosis is made by radiography. Vascular and neurological examinations are required. For immediate treatment include closed reduction and treatment of vascular lesions.

Most anterior dislocation caused by over-stretching, most posterior more easily directed to posterior force on the proximal tibial shaft at the same time knee flexion. Most Knieluxationen caused by severe trauma (eg. As car crashes at high speed), but apparently slight trauma, such as the Into Stepping into a hole and rotary motion of the knee), the knee can dislocate also sometimes, especially in obese patients.

Knee dislocations are frequently accompanied by arterial or nerve injuries. These dislocations can reposition spontaneously before the patient can be medically examined. Diagnosis is made by radiography. Vascular and neurological examinations are required. For immediate treatment include closed reduction and treatment of vascular lesions. Most anterior dislocation caused by over-stretching, most posterior more easily directed to posterior force on the proximal tibial shaft at the same time knee flexion. Most Knieluxationen caused by severe trauma (eg. As car crashes at high speed), but apparently slight trauma, such as the Into Stepping into a hole and rotary motion of the knee), the knee can dislocate also sometimes, especially in obese patients. Dislocation always causes damage structures that support the knee joint instability cause joint instability by extensive ligament injury is a common, long-term complication of knee injury. Other structures that are often violated, are popliteal artery (especially in anterior dislocations) peroneus and tibialis A popliteal artery injury may initially affect only the intima and therefore do not lead to distal limb ischemia is clogged up the artery later. An undiagnosed arterial injury has a high risk for ischemic complications that can lead to amputation. Symptoms and discomfort caused dislocation deformity that is clinically obvious. However, some of these dislocations go by themselves before a medical examination back; In these cases, the knee is swollen and extremely unstable. Fullness in the knee indicates a hematoma or violation of the popliteal artery. Diagnostic radiography Vascular investigation Dislocation should be suspected when an injured knee is strong unstable. Anteroposterior and lateral radiographs are diagnostic of dislocations that can not reduce spontaneously. Vascular and neurological examinations are especially important. Popliteal artery injury should regardless of whether ischemia is obvious is suspected. Thus, some experts believe that serial clinical evaluations of the distal pulse can exclude a violation of the popliteal artery when the pulse over time is normal. The ankle-brachial index (ankle-brachial BP index, ABI) should always be measured (diagnosis); Values ??? 0.9 are highly susceptible to vascular injury. Some experts also recommend duplex ultrasound, even if the ABI is> 0.9, and evidence suggests no ischemia. If the ABI is ? 0.9, or if any evidence suggests ischemia, immediate vascular surgical consultation and / or diagnostic tests are needed. Tests can (should be performed generously), including CT angiography conventional angiography and ultrasound. Immediate reduction therapy In vascular injury, immediate vessel repair and fasciotomy later choice ligament reconstruction Treatment consists of immediate reduction to a 15 ° – diffraction. Vascular lesions to be treated immediately, and when a tissue ischemia is present, a fasciotomy may be necessary. In case of gross instability, an external fixator is sometimes applied. Anteroposterior and lateral radiographs are generally taken to confirm the reduction. Knee ligaments can be reconstructed later, after the swelling has subsided. Many important points Kniedislokationen be accompanied by the popliteal artery or nerve injuries. Kniedislokationen always damaging structures that support the knee joint, leading to joint instability. Most Kniedislokationen are clinically obvious, but they can reposition spontaneously before they are examined; Therefore, if you suspect an dislocation when an injured knee is strong unstable. Measure is always usually hurt the ankle-brachial index, because the popliteal artery by Kniegelenksdislokation. Reposition immediately dislocated knee and resolve vascular lesions.

Health Life Media Team

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