Irreducible Knee Dislocation Associated with Interposition of medial structures: A Case Report
Abstract
We report the case of a patient with an irreducible knee dislocation, multiligamentous injuries, and patellar dislocation following a fall into a ravine. The clinical examination revealed a positive dimple sign. Multiple attempts at closed reduction were unsuccess-ful, requiring an open reduction to expose and release the interposed structures, including the medial capsule, the patellofemoral ligament, and the vastus medialis oblique. A knee immobilizer was applied, and definitive surgery was deferred until soft-tissue conditions improved, at which time a staged multiligament reconstruction was performed, addressing the anterior and posterior cruciate ligaments and the posteromedial corner, with a favorable outcome. Conclusion: Closed reduction should be attempted initially; however, if the medial structures remain entrapped, urgent open reduction is required. Ligament reconstruction is indicated when multiple ligaments are compromised, and the approach to anterior cruciate ligament reconstruction should be individualized based on the patient’s age, physiological status, and physical activity level. A thorough neurological and vascular evaluation is essential due to the risk of serious complications. This case is reported to highlight this uncommon presentation and the importance of open reduction to achieve proper alignment.Downloads
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