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Fracture Dislocations About the Knee

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Advances in Knee Ligament and Knee Preservation Surgery

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Abstract

Fracture dislocations about the knee joint are relatively rare injuries involving both bony and ligamentous disruptions resulting in instability. Fracture dislocations can occur about the tibiofemoral, patellofemoral, and tibiofibular joints; and in paediatric patients often through surrounding physes. There is a high risk of associated vascular and neurological injuries underscoring the importance of having a thorough and organized approach to knee fracture dislocations for both the trauma and general orthopaedist. There are well-described classification systems for ligamentous injuries following true knee dislocations; however, there is no standard system to describe the range of femoral, tibial, fibular and patellar injuries that can occur in association. Selection of appropriate management will depend on the fracture pattern, stability of the fracture fragments and the associated joint. Before preparing any management plans, consideration must be given to associated soft tissue compromise with high-energy patterns, patient factors (age, activity level etc.), neurovascular status and available surgical specialty support. Given the broad scope of this topic, we herein focus on: intra-articular distal femur and proximal tibia fractures; acute tibiofibular injuries; patellar fracture dislocations; and paediatric physeal injuries about the knee.

All images/tables are original material, created for this chapter, with the expection of Fig. 19.1 which is adapted from an open source publication, thereby not requiring copyright permission. Source of Fig. 19.1 is: Pelser, PC. (2010). Controversies in the management of tibial plateau fractures. SA Orthopaedic Journal, 9(3), 75–82.

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Authors and Affiliations

  1. Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, ON, Canada

    Luc Rubinger, Aaron Gazendam, Seper Ekhtiari, Jeffrey Kay, Herman Johal & Darren de SA

  2. Department of Orthopaedics, McMaster Children’s Hospital, Hamilton, ON, Canada

    Darren de SA

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  1. Luc Rubinger
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  2. Aaron Gazendam
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  3. Seper Ekhtiari
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  4. Jeffrey Kay
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  5. Herman Johal
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  6. Darren de SA
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Correspondence to Darren de SA .

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Editors and Affiliations

  1. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

  2. Orthopedic Surgery, Sports Medicine, Hospital for Special Surgery, New York, NY, USA

    Robert G. Marx

  3. MSRC, Division of Sports Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Volker Musahl

  4. Fowler Kennedy Sport Medicine Clinic, London, ON, Canada

    Alan Getgood

  5. Orthopaedic Surgery, Stanford University, Pao Alto, CA, USA

    Seth L. Sherman

  6. Department of Orthopedic Surgery, Antwerp Orthopaedic Center, Antwerpen, Belgium

    Peter Verdonk

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Rubinger, L., Gazendam, A., Ekhtiari, S., Kay, J., Johal, H., de SA, D. (2022). Fracture Dislocations About the Knee. In: Nakamura, N., Marx, R.G., Musahl, V., Getgood, A., Sherman, S.L., Verdonk, P. (eds) Advances in Knee Ligament and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-84748-7_19

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