Evaluation and Management of Knee Dislocation in the Emergency Department.

BACKGROUND: Knee dislocations are a potentially limb-threatening injury, and it is essential that emergency medicine clinicians are aware of them.

OBJECTIVE: This article provides a review of the diagnosis and management of knee dislocation for the emergency provider.

DISCUSSION: Knee dislocations are uncommon injuries with the potential for significant morbidity. A thorough history and examination are important, because 50% of dislocations may have reduced before arrival to the emergency department. Knee dislocations should be quickly reduced in the emergency department setting. The presence of equal pulses does not exclude vascular injury, and all patients should undergo serial vascular examinations and evaluation with ankle-brachial indices. Those with abnormal ankle-brachial indices should receive computed tomographic angiography. Radiographs are important to identify any fractures, while magnetic resonance imaging may be deferred until after admission.

CONCLUSION: Knee dislocation is a potentially dangerous medical condition requiring rapid diagnosis and management. It is essential for emergency clinicians to know how to diagnose and treat this disorder.