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Dizde redükte edilemeyen kırıklı-çıkık

Year 2014, , 363 - 366, 30.05.2014
https://doi.org/10.3944/AOTT.2014.3112

Abstract

Dizde meydana gelen çıkık ve kırıklı çıkıklar, sıklıkla yüksek enerjili travmalar sonrası oluşan ciddi yaralanmalardır. Bu yaralanmaların kapalı tekniklerle redükte edilemiyor olması son derece nadir görülen ve sorunlu bir durum olup, dizin posterolateral, posterior ve lateralinde meydana geldiği bilinmektedir. Dizin etrafındaki kırıklı çıkıkların redükte edilememesi literatürde iki çalışmada yayımlanmış ve tibia platosu ile ilişkisi belirlenememiştir. Bu çalışmada tibia platosunda görülen eşsiz bir kırıklı çıkık olgusu sunuyoruz. Medial menisküsün kırık bölgesinde hapsolması nedeniyle olguda kapalı redüksiyon uygulanamamıştır. Hasta, eşlik eden travmatik beyin hasarı sonrası kurumumuza sevk edilmişti. Bu da resüsitasyon odasına gelişini ilk yaralanma sonrası 10 saat kadar geciktirmişti. İlerleyici şişlik ve ayakta nabzın alınamamasıyla birlikte hastanın acilen ameliyata alınması gerekti. Hastaya dört kompartımanlı fasyotomi ile açık redüksiyon ve internal tespit uygulandı. Cerrahi sonrası hasta hızlı bir şekilde tam olarak iyileşti. Kapalı tekniklerin başarısız olduğu durumlarda kompartıman sendromunun yıkıcı komplikasyonlarının ve nörovasküler yaralanma riskinin önünü almak için açık redüksiyon uygulaması şarttır.

References

  • Huang FS, Simonian PT, Chansky HA. Irreducible posterolateral dislocation of the knee. Arthroscopy 2000;16:323-7. CrossRef
  • Urgüden M, Bilbaşar H, Ozenci AM, Akyildiz FF, Gür S. Irreducible posterolateral knee dislocation resulting from a low-energy trauma. Arthroscopy 2004;20 Suppl 2:50-3. Silverberg DA, Acus R. Irreducible posterolateral knee dislocation associated with interposition of the vastus medialis. Am J Sports Med 2004;32:1313-6. CrossRef
  • Bistolfi A, Massazza G, Rosso F, Ventura S, Cenna E, Drocco L, et al. Non-reducible knee dislocation with interposition of the vastus medialis muscle. J Orthop Traumatol 2011;12:115-8. CrossRef
  • Braun DT, Muffly MT, Altman GT. Irreducible posterolateral knee dislocation with entrapment of the adductor magnus tendon and medial skin dimpling. J Knee Surg 2009;22:366-9. CrossRef
  • Baxamusa TH, Galloway MT. Irreducible knee dislocations secondary to interposed menisci. Am J Orthop (Belle Mead NJ) 2001;30:141-3.
  • Pugh KJ, Wilber JH. Irreducible fracture dislocation of the knee. J Orthop Trauma 1996;10:359-62. CrossRef
  • Shetty GM, Wang JH, Kim SK, Park JH, Park JW, Kim JG, et al. Incarcerated patellar tendon in Hoffa fracture: an unusual cause of irreducible knee dislocation. Knee Surg Sports Traumatol Arthrosc 2008;16:378-81. CrossRef
  • Chen W, Zhang YZ, Su YL, Pan JS. Irreducible lateral knee dislocation with incarceration of the lateral femoral condyle in the posterolateral capsuloligamentary structures: a case report and literature review. Orthop Surg 2011;3:138-42. CrossRef
  • Cady CE, Cardoni AL, Berger MJ. An irreducible posterior knee dislocation. Am J Emerg Med 2007;25:240-2.
  • Robertson A, Nutton RW, Keating JF. Dislocation of the knee. J Bone Joint Surg Br 2006;88:706-11. CrossRef
  • Moore TM. Fracture-dislocation of the knee. Clin Orthop Relat Res 1981;156:128-40. CrossRef
  • Stark E, Stucken C, Trainer G, Tornetta P 3rd. Compartment syndrome in Schatzker type VI plateau fractures and medial condylar fracture-dislocations treated with temporary external fixation. J Orthop Trauma 2009;23:502-6.

Irreducible fracture-dislocation of the knee

Year 2014, , 363 - 366, 30.05.2014
https://doi.org/10.3944/AOTT.2014.3112

Abstract

Dislocation and fracture-dislocation of the knee are serious injuries, often related to high-energy trauma. Irreducibility with closed techniques is an extremely rare and challenging problem that has been described in posterolateral, posterior and lateral knee dislocations. Irreducibility in fracture-dislocations around the knee has only been described twice in the literature and never in association with a tibial plateau fracture. We report a unique case of an irreducible tibial plateau fracture-dislocation in which closed reduction was prevented by incarceration of the medial meniscus within the fracture site. The patient required transfer to our institution due to a concomitant traumatic brain injury. This contributed to a delay of 10 hours from injury to arrival in our resuscitation room. Progressive swelling and absent foot pulses resulted in immediate transfer to the operating theater where open reduction and internal fixation was performed with four-compartmental fasciotomies. The patient made a rapid and full recovery. Where closed techniques have failed, open reduction must then be undertaken in order to prevent the devastating complications of compartment syndrome and neurovascular compromise.

References

  • Huang FS, Simonian PT, Chansky HA. Irreducible posterolateral dislocation of the knee. Arthroscopy 2000;16:323-7. CrossRef
  • Urgüden M, Bilbaşar H, Ozenci AM, Akyildiz FF, Gür S. Irreducible posterolateral knee dislocation resulting from a low-energy trauma. Arthroscopy 2004;20 Suppl 2:50-3. Silverberg DA, Acus R. Irreducible posterolateral knee dislocation associated with interposition of the vastus medialis. Am J Sports Med 2004;32:1313-6. CrossRef
  • Bistolfi A, Massazza G, Rosso F, Ventura S, Cenna E, Drocco L, et al. Non-reducible knee dislocation with interposition of the vastus medialis muscle. J Orthop Traumatol 2011;12:115-8. CrossRef
  • Braun DT, Muffly MT, Altman GT. Irreducible posterolateral knee dislocation with entrapment of the adductor magnus tendon and medial skin dimpling. J Knee Surg 2009;22:366-9. CrossRef
  • Baxamusa TH, Galloway MT. Irreducible knee dislocations secondary to interposed menisci. Am J Orthop (Belle Mead NJ) 2001;30:141-3.
  • Pugh KJ, Wilber JH. Irreducible fracture dislocation of the knee. J Orthop Trauma 1996;10:359-62. CrossRef
  • Shetty GM, Wang JH, Kim SK, Park JH, Park JW, Kim JG, et al. Incarcerated patellar tendon in Hoffa fracture: an unusual cause of irreducible knee dislocation. Knee Surg Sports Traumatol Arthrosc 2008;16:378-81. CrossRef
  • Chen W, Zhang YZ, Su YL, Pan JS. Irreducible lateral knee dislocation with incarceration of the lateral femoral condyle in the posterolateral capsuloligamentary structures: a case report and literature review. Orthop Surg 2011;3:138-42. CrossRef
  • Cady CE, Cardoni AL, Berger MJ. An irreducible posterior knee dislocation. Am J Emerg Med 2007;25:240-2.
  • Robertson A, Nutton RW, Keating JF. Dislocation of the knee. J Bone Joint Surg Br 2006;88:706-11. CrossRef
  • Moore TM. Fracture-dislocation of the knee. Clin Orthop Relat Res 1981;156:128-40. CrossRef
  • Stark E, Stucken C, Trainer G, Tornetta P 3rd. Compartment syndrome in Schatzker type VI plateau fractures and medial condylar fracture-dislocations treated with temporary external fixation. J Orthop Trauma 2009;23:502-6.
There are 12 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Robert Nicholas Green This is me

Mohan Krishna Pullagura This is me

James Patrick Holland This is me

Publication Date May 30, 2014
Published in Issue Year 2014

Cite

APA Green, R. N., Pullagura, M. K., & Patrick Holland, J. (2014). Irreducible fracture-dislocation of the knee. Acta Orthopaedica Et Traumatologica Turcica, 48(3), 363-366. https://doi.org/10.3944/AOTT.2014.3112
AMA Green RN, Pullagura MK, Patrick Holland J. Irreducible fracture-dislocation of the knee. Acta Orthopaedica et Traumatologica Turcica. May 2014;48(3):363-366. doi:10.3944/AOTT.2014.3112
Chicago Green, Robert Nicholas, Mohan Krishna Pullagura, and James Patrick Holland. “Irreducible Fracture-Dislocation of the Knee”. Acta Orthopaedica Et Traumatologica Turcica 48, no. 3 (May 2014): 363-66. https://doi.org/10.3944/AOTT.2014.3112.
EndNote Green RN, Pullagura MK, Patrick Holland J (May 1, 2014) Irreducible fracture-dislocation of the knee. Acta Orthopaedica et Traumatologica Turcica 48 3 363–366.
IEEE R. N. Green, M. K. Pullagura, and J. Patrick Holland, “Irreducible fracture-dislocation of the knee”, Acta Orthopaedica et Traumatologica Turcica, vol. 48, no. 3, pp. 363–366, 2014, doi: 10.3944/AOTT.2014.3112.
ISNAD Green, Robert Nicholas et al. “Irreducible Fracture-Dislocation of the Knee”. Acta Orthopaedica et Traumatologica Turcica 48/3 (May 2014), 363-366. https://doi.org/10.3944/AOTT.2014.3112.
JAMA Green RN, Pullagura MK, Patrick Holland J. Irreducible fracture-dislocation of the knee. Acta Orthopaedica et Traumatologica Turcica. 2014;48:363–366.
MLA Green, Robert Nicholas et al. “Irreducible Fracture-Dislocation of the Knee”. Acta Orthopaedica Et Traumatologica Turcica, vol. 48, no. 3, 2014, pp. 363-6, doi:10.3944/AOTT.2014.3112.
Vancouver Green RN, Pullagura MK, Patrick Holland J. Irreducible fracture-dislocation of the knee. Acta Orthopaedica et Traumatologica Turcica. 2014;48(3):363-6.