Dislocation of the knee arises as a result ofshock on the shin, forcible removal of the lower leg, over-extension. As a result of force action, the joint 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 ligament. It is possible and isolated damage to any element of the ligament apparatus.
Knee joint dislocation: symptoms
There is marked deformity of the limb inarea of the knee joint, misalignment of the hip and shin axes. The region of the joint is sharply painful, there are no movements. Depending on the direction of the force of the dislocation of the knee joint is accompanied by a shift of the shin. Therefore, dislocation 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 volume of active extension of the foot.
Damage to ligaments
If the ligaments are damaged, a restriction is observedmobility, muscle tension, effusion to the joint, edema in the joint region, hemarthrosis. To determine the trauma of the lateral ligaments, an abduction and reduction of the tibia is made with a fixed thigh. To determine the trauma of cruciate ligaments, a drawer test is performed.
X-ray examination is necessaryto conduct even with a pronounced clinical picture. This diagnostic method is performed to exclude damage to bones. The divergence of the articular ends of bones by 10 mm or more indicates a damage to the cruciate ligaments.
Dislocation of the knee joint: treatment
Консервативное лечение.The dislocation of the knee joint is necessarily under anesthesia. The mechanism of reposition is completely reversed to the mechanism of injury: the limb is stretched along the length and pressure is applied to the displaced articulate ends in the direction opposite to the trauma. Conservative treatment of ligament damage involves knee joint puncture, fluid evacuation and immobilization for 3 weeks. If the ligaments are inconsistent, an operation is performed.
Surgical treatment.When the femur is pinched in the damaged joint capsule, the dislocation of the knee joint is reset only by means of an operation. After a closed reduction, 3-4 days after surgery, surgery is carried out to restore the ligaments and the capsule of the joint. In the early stages of the operation is carried out with a complete rupture of the ligaments: impose several interrupted sutures or carry out allo or autoplasty. Fixing the knee joint with plaster from the toes of the feet to the hip joint when it is impossible to perform a surgical procedure is performed in the most physiological position of the limb: bending at the knee joint up to 150-160about. Fixation lasts 2 months.
Physiotherapy. After drying, the gypsum is assigned UHF. After removing the dressing - rehabilitation: massage, heat treatments, exercise therapy.
