Durakbaşa Mehmet Oğuz, Ulkü Kerem, Ermiş Mehmet Nurullah
Department of Orthopaedics, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Acta Orthop Traumatol Turc. 2011;45(5):382-6. doi: 10.3944/AOTT.2011.2484.
Posterolateral knee dislocations are generally irreducible due to the interposition of the medial capsule and retinaculum. These injuries have a 'dimple sign' which shows the invagination of the tissues in the medial joint line. We present an unusual case of an open posterolateral traumatic knee dislocation (KD-4 [ACL/PCL/MCL/LCL-PLC torn] open knee dislocation) without a 'dimple sign'. Closed reduction attempts were unsuccessful. In surgery, it was found that the medial meniscus was detached from the meniscocapsular junction and entrapped in the joint. The medial meniscus was extracted from the joint, and the joint was reduced. The medial meniscus was sutured to the meniscocapsular junction with anchors. This is the first study reporting medial meniscus interposition in an open posterolateral knee dislocation. Moreover, the presented case is peculiar because although it was a posterolateral knee dislocation, the posterolateral ligament complex was also torn.
膝关节后外侧脱位通常因内侧关节囊和支持带的嵌入而难以复位。这些损伤有一个“酒窝征”,表现为内侧关节线处组织的内陷。我们报告一例罕见的开放性膝关节后外侧创伤性脱位(KD-4 [前交叉韧带/后交叉韧带/内侧副韧带/外侧副韧带-后外侧韧带复合体撕裂]开放性膝关节脱位),无“酒窝征”。闭合复位尝试未成功。手术中发现内侧半月板从半月板关节囊连接处分离并嵌顿于关节内。将内侧半月板从关节中取出,然后关节复位。用锚钉将内侧半月板缝合至半月板关节囊连接处。这是首次报道开放性膝关节后外侧脱位时内侧半月板嵌入的研究。此外,该病例很特殊,因为尽管是膝关节后外侧脱位,但后外侧韧带复合体也有撕裂。