Surgical outcomes after traumatic open knee disloc

Authors: Joseph J King Douglas L Cerynik James A Blair Susan P Harding James A Tom

Publish Date: 2009/02/10

Volume: 17, Issue: 9, Pages: 1027-1032

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Abstract

The purpose of this study is to describe the types of injuries and surgical treatments associated with open knee dislocations and to present the functional outcomes of these patients Between 2001 and 2005 the medical records of patients that sustained traumatic open knee dislocations at our Level 1 Trauma Center were retrospectively reviewed Initial surgical intervention was performed in all patients including placement of spanning external fixator repair of vascular injuries if necessary and irrigation and debridement of the open wounds Ligamentous reconstruction was delayed until after limb salvage The Short Form12 was the primary outcome measure Seven patients five male two female had a mean age of 319 years range 22–44 at the time of injury five right two left Motorcycle accident was the most common cause 57 Followup was a mean 276 months The PCL was damaged in all patients Three patients underwent angiography for absent/diminished pulses on initial exam with two requiring operative intervention Three patients had associated common peroneal nerve injury one iatrogenic Ten 107 operative procedures were performed per patient range 5–18 with an average of 66 debridements range 2–11 Infection rate was 43 with one patient undergoing amputation for infection Good to excellent results were found in 33 of patients Most patients 86 report some residual symptomatic or functional deficit Due to the injury complexity in open traumatic knee dislocations the surgical treatment is extensive and challenging While infection rates are high aggressive individualized treatment can lead to satisfactory outcome although full return to activity is difficult to achieve using current treatment methods

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