Dislocation of the knee joint occurs as a result of a blow to the lower leg, forcible abduction of the lower leg, and over extension. As a result of the force action, the articular surfaces of the tibia and femur are displaced . Depending on the displacement of the tibia, the anterior and posterior dislocations are distinguished. Injury leads to damage to the ligaments of the joint. The most frequent and less favorable combination: damage to the medial meniscus, medial lateral and anterior cruciate ligaments. Perhaps isolated damage to any element of the ligamentous apparatus.
Dislocation of the knee: symptoms
Marked deformation of the limb in the knee joint, mismatch of the axes of the thigh and lower leg. The joint area is sharply painful, there are no movements. Depending on the direction of the force, a dislocation of the knee joint is accompanied by a displacement of the lower leg. Therefore, dislocations can be complicated by compression of large vessels and nerves. This is the basis for always checking the pulse on the vessels of the foot and the amount of active extension of the foot.
Ligament damage
If the ligaments are damaged, there is a restriction of mobility, muscle tension, effusion in the joint, swelling in the joint, hemarthrosis. To determine the injury of the lateral ligaments , abduction and adduction of the lower leg with a fixed thigh are performed. To determine the cruciate ligament injury, a drawer test is performed.
X-ray examination must be carried out even with a pronounced clinical picture. This diagnostic method is performed to exclude bone damage. A discrepancy in the articular ends of bones of 10 mm or more indicates damage to the cruciate ligaments.
Dislocation of the knee: treatment
Conservative treatment. Dislocation of the knee joint is set necessarily under anesthesia. The reposition mechanism is completely opposite to the trauma mechanism: the limb is extended in length and pressure is applied to the displaced articular ends in the opposite direction to the trauma. Conservative treatment of ligament damage involves puncture of the knee joint, fluid evacuation and immobilization for 3 weeks. If the ligaments are insolvent, an operation is performed.
Surgical treatment. When the femur is infringed in the damaged joint capsule, the dislocation of the knee joint is corrected only by surgery. After a closed reduction, after 3-4 days, surgery is performed to restore the ligaments and capsule of the joint. In the early stages, the operation is performed with a complete rupture of the ligaments: a few nodal sutures are applied or allo or autoplasty is performed. Fixation of the knee joint with gypsum from the toes to the hip joint when it is impossible to carry out surgery is carried out in the most physiological position of the limb: flexion in the knee joint to 150-160 about . Fixation lasts 2 months.
Physiotherapy. After the gypsum has dried, UHF is prescribed. After removing the bandage - rehabilitation: massage, thermal procedures, exercise therapy.