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Fracture Dislocations of the Knee

  • Sanjeev AnandEmail author
Chapter

Abstract

Fracture dislocations of the knee joint are complex injuries usually sustained following high velocity trauma. It is important to identify ligamentous injuries in patients with fractures around the knee joint, as persistent instability can lead to a poor outcome. Certain fracture patterns are more commonly associated with knee ligamentous injuries and can serve as signposts to them. Management of these injuries requires a combination of the principles of fracture management along with ligament repair and reconstruction. This chapter will cover the common fractures associated with knee ligament injuries and discuss management strategies.

Keywords

Fracture dislocation Multiligament knee injuries Ligament injury Avulsion fractures Knee joint 

References

  1. 1.
    Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am. 1963;45:889–904.CrossRefGoogle Scholar
  2. 2.
    Schenck R, Schenck RC. Classification of the knee dislocations. Oper Tech Sports Med. 2003;11(3):193–8.CrossRefGoogle Scholar
  3. 3.
    Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma. 1997;11(7):525–9.CrossRefGoogle Scholar
  4. 4.
    Walker DM, Kennedy JC. Occult knee ligament injuries associated with femoral shaft fractures. Am J Sports Med. 1980;8(3):172–4.CrossRefGoogle Scholar
  5. 5.
    Mckee L, Ibrahim MS, Lawrence T, Pengas IP, Khan WS. Current concepts in acute knee dislocation: the missed diagnosis? Open Orthop J. 2014;8(1):5–162.CrossRefGoogle Scholar
  6. 6.
    Porrino J, Richardson ML, Hovis K, Twaddle B, Gee A. Association of tibial plateau fracture morphology with ligament disruption in the context of multiligament knee injury. Curr Probl Diagn Radiol. 2017  https://doi.org/10.1067/j.cpradiol.2017.09.001. [Epub ahead oprin].CrossRefGoogle Scholar
  7. 7.
    Medina Bs O, Arom Bs GA, Yeranosian MG, Petrigliano FA, Mcallister DR. Vascular and nerve injury after knee dislocation a systematic review. Clin Orthop Relat Res. 2014;472(9):2621–9.CrossRefGoogle Scholar
  8. 8.
    Bui KL, Ilaslan H, Parker RD, Sundaram M. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings. Skeletal Radiol. 2008;37(7):653–61.CrossRefGoogle Scholar
  9. 9.
    Azar FM, Brandt JC, Miller Iii RH, Phillips BB. Ultra-low-velocity knee dislocations. Am J Sport Med. 2011;30(10):2170–4.CrossRefGoogle Scholar
  10. 10.
    Werner BC, Gwathmey FW, Higgins ST, Hart JM, Miller MD. Ultra-low velocity knee dislocations. Am J Sports Med. 2014;42(2):358–63.CrossRefGoogle Scholar
  11. 11.
    Ibrahim DA, Swenson A, Sassoon A, Fernando ND. Classifications in brief: the Tscherne classification of soft tissue injury. Clin Orthop Relat Res. 2017;475(2):560–4.CrossRefGoogle Scholar
  12. 12.
    Tull F, Borrelli J. Soft-tissue injury associated with closed fractures: evaluation and management. J Am Acad Orthop Surg. 2003;11(6):431–8.CrossRefGoogle Scholar
  13. 13.
    Demirkale I, Tecimel O, Celik I, Kilicarslan K, Ocguder A, Dogan M. The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations. Foot Ankle Surg. 2013;19(3):188–93.CrossRefGoogle Scholar
  14. 14.
    Dendrinos GK, Kontos S, Katsenis D, Dalas A. Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Joint Surg Br. 1996;78(5):710–7.CrossRefGoogle Scholar
  15. 15.
    Dillin L, Slabaugh P. Delayed wound healing, infection, and nonunion following open reduction and internal fixation of tibial plafond fractures. J Trauma. 1986;26(12):1116–9.CrossRefGoogle Scholar
  16. 16.
    Egol KA, Tejwani NC, Capla EL, Wolinsky PL, Koval KJ. Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol. J Orthop Trauma [Internet]. 2005;19(7):448–55.CrossRefGoogle Scholar
  17. 17.
    Sirkin M, Sanders R, DiPasquale T, Herscovici D. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma. 1999;13(2):78–84.CrossRefGoogle Scholar
  18. 18.
    Pape H, Andruszkow H, Pfeifer R, Hildebrand F, Barkatali B. Options and hazards of the early appropriate care protocol for trauma patients with major fractures: towards safe definitive surgery. Injury. 2016;47(4):787–91.CrossRefGoogle Scholar
  19. 19.
    Vallier HA, Wang X, Moore TA, Wilber JH, Como JJ. Timing of orthopaedic surgery in multiple trauma patients. J Orthop Trauma. 2013;27(10):543–51.CrossRefGoogle Scholar
  20. 20.
    Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968–1975. Clin Orthop Relat Res [Internet]. 1979;138:94–104.Google Scholar
  21. 21.
    Colletti P, Greenberg H, Terk MR. MR findings in patients with acute tibial plateau fractures. Comput Med Imaging Graph. 1996;20(5):389–94.CrossRefGoogle Scholar
  22. 22.
    Bennett WF, Browner B. Tibial plateau fractures: a study of associated soft tissue injuries. J Orthop Trauma. 1994;8(3):183–8.CrossRefGoogle Scholar
  23. 23.
    Stannard JP, Lopez R, Volgas D. Soft tissue injury of the knee after tibial plateau fractures. J Knee Surg. 2010;23(4):187–92.CrossRefGoogle Scholar
  24. 24.
    Gardner MJ, Yacoubian S, Geller D, Suk M, Mintz D, Potter H, et al. The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients. J Orthop Trauma. 2005;19(2):79–84.CrossRefGoogle Scholar
  25. 25.
    Warner SJ, Garner MR, Schottel PC, Fabricant PD, Thacher RR, Loftus ML, et al. The effect of soft tissue injuries on clinical outcomes after tibial plateau fracture fixation. J Orthop Trauma. 2018;32(3):141–7.CrossRefGoogle Scholar
  26. 26.
    Moore TM. Fracture–dislocation of the knee. Clin Orthop Relat Res. 1981;156:128–40.Google Scholar
  27. 27.
    Delamarter RB, Hohl M, Hopp E. Ligament injuries associated with tibial plateau fractures. Clin Orthop Relat Res. 1990;250:226–33.Google Scholar
  28. 28.
    Luo CF, Sun H, Zhang B, Zeng BF. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma. 2010;24(11):683–92.CrossRefGoogle Scholar
  29. 29.
    Wang Y, Luo C, Zhu Y, Zhai Q, Zhan Y, Qiu W, et al. Updated three-column concept in surgical treatment for tibial plateau fractures—a prospective cohort study of 287 patients. Injury. 2016;47(7):1488–96.CrossRefGoogle Scholar
  30. 30.
    Potocnik P, Acklin YP, Sommer C. Operative strategy in postero-medial fracture-dislocation of the proximal tibia. Injury. 2011;42(10):1060–5.CrossRefGoogle Scholar
  31. 31.
    Larson RV. Isometry of the lateral collateral and popliteofibular ligaments and techniques for reconstruction using a free semitendinosus tendon graft. Oper Tech Sports Med. 2001;9(2):84–90.CrossRefGoogle Scholar
  32. 32.
    Delamarter RB, Hohl M, Hopp E. Ligament injuries associated with tibial plateau fractures. Clin Orthop Relat Res. 1990;250:226–33.Google Scholar
  33. 33.
    Cinque ME, Godin JA, Moatshe G, Chahla J, Kruckeberg BM, Pogorzelski J, et al. Do tibial plateau fractures worsen outcomes of knee ligament injuries? a matched cohort analysis. Orthop J Sport Med [Internet]. 2017;5(8):2325967117723895. Available from: http://journals.sagepub.com/doi/10.1177/2325967117723895.CrossRefGoogle Scholar
  34. 34.
    Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223(4):321–8.CrossRefGoogle Scholar
  35. 35.
    Sonnery-Cottet B, Matthew D, Fayard J-M, Ferretti A, Helito CP, et al. Anterolateral ligament expert group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament–deficient knee. J Orthop Traumatol. 2017;18(2):91–106.CrossRefGoogle Scholar
  36. 36.
    Musahl V, Herbst E, Burnham JM, Fu FH. The anterolateral complex and anterolateral ligament of the knee. J Am Acad Orthop Surg. 2018;26(8):261–7.CrossRefGoogle Scholar
  37. 37.
    Amis A, Zaffagnini S, Musahl V. The anterolateral aspect of the knee: the state of play. Knee Surg Sport Traumatol Arthrosc. 2017;25(4):989–90.CrossRefGoogle Scholar
  38. 38.
    Shaikh H, Herbst E, Rahnemai-Azar AA, Bottene Villa Albers M, Naendrup J-H, Musahl V, et al. The Segond fracture is an avulsion of the anterolateral complex. Am J Sports Med. 2017;45(10):2247–52.CrossRefGoogle Scholar
  39. 39.
    Marwan Y, Kulkarni S, Addar A, Algarni N, Tamimi I, Boily M, et al. Anterolateral ligament injury in knee dislocations. Arthrosc J Arthrosc Relat Surg. 2018;34(6):1891–7.CrossRefGoogle Scholar
  40. 40.
    Kennedy MI, LaPrade RF, Marwan by. Editorial commentary: is the anterolateral ligament always injured in knee dislocations? Does it matter? Arthrosc J Arthrosc Relat Surg. 2018;34(6):1898–9.CrossRefGoogle Scholar
  41. 41.
    Kose O, Ozyurek S, Turan A, Guler F. Reverse Segond fracture and associated knee injuries: a case report and review of 13 published cases. Acta Orthop Traumatol Turc. 2016;50(5):587–91.CrossRefGoogle Scholar
  42. 42.
    Hall FM, Hochman MG. Medial Segond-type fracture: cortical avulsion off the medial tibial plateau associated with tears of the posterior cruciate ligament and medial meniscus. Skeletal Radiol. 1997;26(9):553–5.CrossRefGoogle Scholar
  43. 43.
    Frassica FJ, Sim FH, Staeheli JW, Pairolero PC. Dislocation of the knee. Clin Orthop Relat Res. 1991;263:200–5.Google Scholar
  44. 44.
    Sisto DJ, Warren RF. Complete knee dislocation. A follow-up study of operative treatment. Clin Orthop Relat Res. 1985;198:94–101.Google Scholar
  45. 45.
    Strauss EJ, Kaplan DJ, Weinberg ME, Egol J, Jazrawi LM. Arthroscopic management of tibial spine avulsion fractures. J Am Acad Orthop Surg. 2018;26(10):360–7.CrossRefGoogle Scholar
  46. 46.
    O’Malley M, Reardon P, Pareek A, Krych A, Levy B, Stuart M. Extensor mechanism disruption in knee dislocation. J Knee Surg. 2015;29(04):293–9.CrossRefGoogle Scholar
  47. 47.
    Wissman RD, Verma S, Kreeger M, Robertson M. Extensor mechanism injuries in tibiofemoral dislocations. J Comput Assist Tomogr. 2009;33(1):145–9.CrossRefGoogle Scholar
  48. 48.
    Tulio M, Caldas L, Starling Malheiros D, Lazzaroni AP, Avelino EA, Santos AJ. Injury of the knee ligaments associated with ipsilateral femoral shaft fractures. Rev Bras Ortop. 2013;48(5):438–40.CrossRefGoogle Scholar
  49. 49.
    Dickson KF, Galland MW, Barrack RL, Neitzschman HR, Harris MB, Myers L, et al. Magnetic resonance imaging of the knee after ipsilateral femur fracture. J Orthop Trauma. 2002;16(8):567–71.CrossRefGoogle Scholar
  50. 50.
    van Raay JJ, Raaymakers EL, Dupree HW. Knee ligament injuries combined with ipsilateral tibial and femoral diaphyseal fractures: the “floating knee”. Arch Orthop Trauma Surg. 1991;110(2):75–7.CrossRefGoogle Scholar
  51. 51.
    Gupta S, Fazal M, Haddad F. Traumatic anterior knee dislocation and tibial shaft fracture: a case report. J Orthop Surg. 2007;15(1):81–3.CrossRefGoogle Scholar
  52. 52.
    Aydın A, Atmaca H, Müezzinoğlu ÜS. Anterior knee dislocation with ipsilateral open tibial shaft fracture: a 5-year clinical follow-up of a professional athlete. Musculoskelet Surg. 2013;97(2):165–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Trauma and OrthopaedicsLeeds University and Leeds Teaching Hospitals NHS TrustLeedsUK

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