Knee dislocations and associated fractures: risk factors for surgical reduction.
Arch Orthop Trauma Surg
; 144(7): 3011-3015, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38935141
ABSTRACT
INTRODUCTION:
Dissociation of the knee joint, or knee dislocations (KD), can lead to severe complications, often resulting in multiligament injuries. A subset of these injuries are irreducible by closed reduction and require open reduction. Identifying KDs that necessitate surgical intervention is crucial for optimal outcomes. While previous studies have explored various risk factors, the influence of associated fractures is less understood. MATERIALS ANDMETHODS:
We queried the Trauma Quality Improvement Program (TQIP) database from 2017 to 2021, for non-congenital closed knee dislocations requiring surgery. Demographic variables were collected, and ICD-10 codes were used to identify associated tibia, femur, acetabular, and fibula fractures. ICD-10 codes were also used to identify nerve injuries and vascular injuries. Multivariate logistic regression was used to assess factors influencing the need for surgical reduction (SR).RESULTS:
A total of 1,467 patients with KDs were included in the study, of which 411 (28.0%) underwent open surgical reduction (SR) while 1,056 (72.0%) were treated with nonsurgical closed reduction (nSR). Factors associated with SR included concomitant tibia fracture (OR = 1.683, C.I 1.255-2.256, p < 0.001) and fibula fracture (OR = 1.457, C.I 1.056-2.011, p = 0.022). Vascular injury had lower odds of SR (OR = 0.455, C.I 0.292-0.708, p < 0.001).CONCLUSION:
Our study demonstrated that KDs presenting with concomitant tibia and/or fibula fractures are more likely to require SR. The difficulty posed to closed reduction may be due to the influence of these fracture patterns on surrounding soft tissue as well as the lack of a stable bone structure necessary for achieving proper reduction. Physicians should be aware of the potential risk of this fracture pattern when caring for patients with KDs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Luxação do Joelho
Limite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Arch Orthop Trauma Surg
/
Arch. orthop. trauma surg
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Archives of orthopaedic and trauma surgery
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos