Patella dislocation: Difference between revisions
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*Occurs with trauma to an extended knee with externally rotated foot and twisting motion<ref>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</ref> | *Occurs with trauma to an extended knee with externally rotated foot and twisting motion<ref>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</ref> | ||
*Acute: in traumatic injury, equal gender<ref name="epi">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</ref> | *Acute: in traumatic injury, equal gender<ref name="epi">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</ref> | ||
*Chronic: women/teenage girls<ref name="epi></ref> | *Chronic: women/teenage girls<ref name="epi"></ref> | ||
*Commonly lateral displacement and unable to extend knee | *Commonly lateral displacement and unable to extend knee | ||
[[File:Patellar dislocation.jpg|thumb|patella dislocates laterally]] | [[File:Patellar dislocation.jpg|thumb|patella dislocates laterally]] | ||
Revision as of 16:03, 29 December 2014
Background
- Occurs with trauma to an extended knee with externally rotated foot and twisting motion[1]
- Acute: in traumatic injury, equal gender[2]
- Chronic: women/teenage girls[2]
- 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 rule out 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)[3]
- 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
- ↑ 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
- ↑ 2.0 2.1 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
- ↑ 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