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Open Knee Dislocation, Triple Intra-Articular Fractures and Patellar Tendon Rupture: Case Report of a Knee Disaster Treated With Aggressive Irrigation/Debridement, Early Anatomic Reduction and Internal Fixation Publisher Pubmed



Vosoughi F1 ; Vosoughi F1 ; Kalantar SH1, 3
Authors
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Authors Affiliations
  1. 1. Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Orthopedic and Trauma Surgery, Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Shariati hospital, Tehran, Iran
  3. 3. Orthopedic Surgery Department, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, 1419733141, Iran

Source: BMC Musculoskeletal Disorders Published:2022


Abstract

Background: Open knee fracture-dislocation is a rare orthopedic injury. However, the importance of its correct management could not be overstated. To the best of our knowledge, this is the fifth study reporting a case with simultaneous Hoffa fracture and knee dislocation and the 1st study describing a patient with open plateau fracture-dislocation accompanied with Hoffa fracture, patella fracture, and patellar tendon tear. In addition, this report is noticeable as our case had no gross ligament injury unlike frequent association of knee dislocation with knee collateral ligament damage. Case presentation: In this study, we describe a 34-year-old motorcyclist referred to our center following a motor car accident. Further work-up revealed an open irreducible posterolateral knee dislocation, type 5 Hohl and Moore plateau fracture, lateral femoral condyle Hoffa’s fracture, patellar fracture, and patellar tendon tear of his right knee. During an open reduction, it turned out that an entrapped lateral meniscus prevented the joint to be reduced by closed means. After applying a temporary external fixator, the patient was finally managed with open reduction and internal fixation. Conclusion: Irreducible knee dislocation needs further work up to rule out any interposed soft tissue into the joint. Aggressive irrigation/ debridement, early anatomic reduction, and internal fixation may help reduce open fracture complications including infection, non-union, and stiffness. © 2022, The Author(s).