Patella dislocation: Difference between revisions
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==Background== | ==Background== | ||
* | *extended knee with externally rotated foot and twisting motion | ||
*acute: in traumatic injury, equal genders | |||
*chronic: women/teenage girls | |||
*commonly lateral displacement and unable to extend knee | |||
[[File:Patellar dislocation.jpg|thumb|patella dislocates laterally]] | [[File:Patellar dislocation.jpg|thumb|patella dislocates laterally]] | ||
[[File:Patellar Dislocation Relocation.jpg|thumb|Relocation with lateral pressure on dislocated patella]] | [[File:Patellar Dislocation Relocation.jpg|thumb|Relocation with lateral pressure on dislocated patella]] | ||
==Diagnosis== | ==Diagnosis== | ||
* | *Patella is usually displaced laterally; knee is held in flexion | ||
*acute: often with large hemarthrosis | |||
*chronic: little to no swelling | |||
==Work-Up== | ==Work-Up== | ||
*Post-reduction x-ray | *xray if traumatic mechanism to r/o fracture | ||
** | *do not need xay prior to reduction if chronic | ||
*Post-reduction x-ray: confirm reduction, eval for fractures and loose bodies (avulsions, misalignment, etc)<ref>Krause E A. et al. Pediatric lateral patellar dislocation: is there a role for plain radiography in the emergency department? J Emerg Med. 2013 Jun;44(6):1126-31</ref> | |||
*common associated fractures | |||
**medial patella facet | |||
**lateral femoral condyle | |||
==Treatment== | ==Treatment== | ||
*Reduce; do not need x-rays prior to reduction | *Reduce; do not need x-rays prior to reduction | ||
**Extend knee and slide patella back into place | **Extend knee and slide patella back into place | ||
**Knee immobilizer, NSAIDs, partial weight-bearing | |||
**Orthopedic followup within 1-2wks | |||
*Unable to Reduce or Loose bodies/fracture on post-reduction imaging | |||
*Orthopedic followup within 1-2wks | |||
* | |||
*Obtain immediate ortho consult | *Obtain immediate ortho consult | ||
==Source== | ==Source== | ||
*Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM. Epidemiology and natural history of acute patellar dislocation. AJSM 2004;32:1114-1121 | |||
*Review of Orthopaedics, 6th Edition, Mark D. Miller MD, Stephen R. Thompson MBBS MEd FRCSC, Jennifer Hart MPAS PA-C ATC, an imprint of Elsevier, Philadelphia, Copyright 2012 | |||
*AAOS Comprehensive Orthopaedic Review, Jay R. Leiberman. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2009 | |||
==See Also== | ==See Also== | ||
Revision as of 15:59, 29 December 2014
Background
- extended knee with externally rotated foot and twisting motion
- acute: in traumatic injury, equal genders
- chronic: women/teenage girls
- commonly lateral displacement and unable to extend knee
Diagnosis
- Patella is usually displaced laterally; knee is held in flexion
- acute: often with large hemarthrosis
- chronic: little to no swelling
Work-Up
- xray if traumatic mechanism to r/o fracture
- do not need xay prior to reduction if chronic
- Post-reduction x-ray: confirm reduction, eval for fractures and loose bodies (avulsions, misalignment, etc)[1]
- common associated fractures
- medial patella facet
- lateral femoral condyle
Treatment
- Reduce; do not need x-rays prior to reduction
- Extend knee and slide patella back into place
- Knee immobilizer, NSAIDs, partial weight-bearing
- Orthopedic followup within 1-2wks
- Unable to Reduce or Loose bodies/fracture on post-reduction imaging
- Obtain immediate ortho consult
Source
- Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM. Epidemiology and natural history of acute patellar dislocation. AJSM 2004;32:1114-1121
- Review of Orthopaedics, 6th Edition, Mark D. Miller MD, Stephen R. Thompson MBBS MEd FRCSC, Jennifer Hart MPAS PA-C ATC, an imprint of Elsevier, Philadelphia, Copyright 2012
- AAOS Comprehensive Orthopaedic Review, Jay R. Leiberman. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2009
See Also
- ↑ Krause E A. et al. Pediatric lateral patellar dislocation: is there a role for plain radiography in the emergency department? J Emerg Med. 2013 Jun;44(6):1126-31