Pache Santiago, Vázquez José María, Chahla Jorge, Moatshe Gilbert, LaPrade Robert F
Sanatorio Cantegril, Traumatología y Ortopedia, Punta del Este, Maldonado, Uruguay.
Rush University Medical Center, Chicago, Illinois.
JBJS Case Connect. 2023 Mar 16;13(1). doi: e22.00792. eCollection 2023 Jan 1.
A 62-year-old male patient suffered an irreducible posterolateral knee dislocation after a horse fell on him. The left knee was slightly flexed with a medial dimple sign present. The medial retinaculum, medial patellofemoral ligament, posteromedial corner structures, and vastus medialis obliquus (VMO) muscle were incarcerated in the medial joint. An open reduction and the medial retinaculum and VMO gap were repaired, and the knee was stabilized in an external fixator for 4 weeks. At 32-month follow-up, the patient had almost full knee motion and good subjective outcomes with moderate residual joint laxity.
Early clinical diagnosis of irreducible knee dislocations and emergent open reduction should be performed to reduce the risk of soft-tissue compromise.
一名62岁男性患者被马摔倒后发生不可复位的膝关节后外侧脱位。左膝轻度屈曲，存在内侧酒窝征。内侧支持带、内侧髌股韧带、后内侧角结构以及股内侧斜肌（VMO）嵌入内侧关节。进行了切开复位，并修复了内侧支持带和VMO间隙，膝关节用外固定器固定4周。在32个月的随访中，患者膝关节活动几乎完全恢复，主观结果良好，但仍有中度关节松弛。
应尽早对不可复位的膝关节脱位进行临床诊断并紧急切开复位，以降低软组织受损的风险。
