Knee Dislocation (KD) IV Injuries of the Knee: Presentation, Treatment, and Outcomes.

"KDIV ligamentous injuries of the knee are frequently high-energy injuries with significant soft tissue disruption, gross knee instability, and rarely are treated nonoperatively. KDIVs frequently require external fixation, but when presenting in an isolated fashion can be reconstructed in one setting. Five presentations of KDIV injury are described: closed with multitrauma/closed head injury requiring external fixation, irreducible KDIV requiring semi-emergent open reduction and repair, isolated KDIV without arterial injury undergoing 4-ligament reconstruction after regaining motion, KDIV with varus and slight thrust undergoing medial opening osteotomy before ligament reconstruction, and KDIV with failed ligaments requiring revision and posterior tibial tendon transfer."