Maslaris Alexander, Brinkmann Olaf, Bungartz Matthias, Krettek Christian, Jagodzinski Michael, Liodakis Emmanouil
Department of Orthopaedics, Rudolf-Elle-Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klostersnitzer Straße 81, 07607, Eisenberg, Germany.
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Eur J Orthop Surg Traumatol. 2018 Aug;28(6):1001-1015. doi: 10.1007/s00590-018-2148-4. Epub 2018 Feb 22.
Traumatic knee dislocation is a rare but potentially limb-threatening injury. Thus proper initial diagnosis and treatment up to final ligament reconstruction are extremely important and a precondition to successful outcomes. Reports suggest that evidence-based systematic approaches lead to better results. Because of the complexity of this injury and the inhomogeneity of related literature, there are still various controversies and knowledge gaps regarding decision-making and step-sequencing in the treatment of acute multi-ligament knee injuries and knee dislocations. The use of ankle-brachial index, routine or selective angiography, braces, joint-spanning or dynamic external fixation, and the necessity of initial ligament re-fixation during acute surgery constitutes current topics of a scholarly debate. The aim of this article was to provide a comprehensive literature review bringing light into some important aspects about the initial treatment of knee dislocation (vascular injury, neural injury, immobilization techniques) and finally develop an accurate data-based universal algorithm, enabling attending physicians to become more acquainted with the management of acute knee dislocation.
创伤性膝关节脱位是一种罕见但可能危及肢体的损伤。因此，从最初的正确诊断和治疗到最终的韧带重建，都极为重要，且是取得成功结果的前提条件。报告表明，基于证据的系统方法能带来更好的效果。由于这种损伤的复杂性以及相关文献的不均一性，在急性多韧带膝关节损伤和膝关节脱位的治疗决策及步骤顺序方面，仍存在各种争议和知识空白。踝臂指数的使用、常规或选择性血管造影、支具、跨关节或动态外固定，以及急性手术期间初始韧带重新固定的必要性，构成了学术辩论的当前话题。本文的目的是提供一篇全面的文献综述，阐明膝关节脱位初始治疗的一些重要方面（血管损伤、神经损伤、固定技术），并最终开发一种基于准确数据的通用算法，使主治医生能更熟悉急性膝关节脱位的管理。
