Knee dislocations and associated fractures: risk factors for surgical reduction
- 27.06.2024
- Orthopaedic Surgery
Erschienen in:
- Verfasst von
-
Victor Koltenyuk
Korrespondierender Autor Victor Koltenyuk
- School of Medicine, New York Medical College, 10595, Valhalla, Valhalla, USA
-
Matthew Merckling
Matthew Merckling
- School of Medicine, New York Medical College, 10595, Valhalla, Valhalla, USA
-
Matan Grunfeld
Matan Grunfeld
- School of Medicine, New York Medical College, 10595, Valhalla, Valhalla, USA
-
Cyrus Luczkow
Cyrus Luczkow
- School of Medicine, New York Medical College, 10595, Valhalla, Valhalla, USA
-
Kevin Berardino
Kevin Berardino
- Department of Orthopedic Surgery, Westchester Medical Center, New York Medical College, Valhalla, USA
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David Wellman
David Wellman
- Department of Orthopedic Surgery, Westchester Medical Center, New York Medical College, Valhalla, USA
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Rachel Talley Bruns
Rachel Talley Bruns
- Department of Orthopedic Surgery, Westchester Medical Center, New York Medical College, Valhalla, USA
-
Daniel Zelazny
Daniel Zelazny
- Department of Orthopedic Surgery, Westchester Medical Center, New York Medical College, Valhalla, USA
- Erschienen in
- Archives of Orthopaedic and Trauma Surgery | Ausgabe 7/2024
Abstract
Introduction
Dissociation of the knee joint, or knee dislocations (KD), can lead to severe complications, often resulting in multiligament injuries. A subset of these injuries are irreducible by closed reduction and require open reduction. Identifying KDs that necessitate surgical intervention is crucial for optimal outcomes. While previous studies have explored various risk factors, the influence of associated fractures is less understood.
Materials and Methods
We queried the Trauma Quality Improvement Program (TQIP) database from 2017 to 2021, for non-congenital closed knee dislocations requiring surgery. Demographic variables were collected, and ICD-10 codes were used to identify associated tibia, femur, acetabular, and fibula fractures. ICD-10 codes were also used to identify nerve injuries and vascular injuries. Multivariate logistic regression was used to assess factors influencing the need for surgical reduction (SR).
Results
A total of 1,467 patients with KDs were included in the study, of which 411 (28.0%) underwent open surgical reduction (SR) while 1,056 (72.0%) were treated with nonsurgical closed reduction (nSR). Factors associated with SR included concomitant tibia fracture (OR = 1.683, C.I: 1.255-2.256, p < 0.001) and fibula fracture (OR = 1.457, C.I: 1.056-2.011, p = 0.022). Vascular injury had lower odds of SR (OR = 0.455, C.I: 0.292-0.708, p < 0.001).
Conclusion
Our study demonstrated that KDs presenting with concomitant tibia and/or fibula fractures are more likely to require SR. The difficulty posed to closed reduction may be due to the influence of these fracture patterns on surrounding soft tissue as well as the lack of a stable bone structure necessary for achieving proper reduction. Physicians should be aware of the potential risk of this fracture pattern when caring for patients with KDs.
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- Titel
- Knee dislocations and associated fractures: risk factors for surgical reduction
- Verfasst von
-
Victor Koltenyuk
Matthew Merckling
Matan Grunfeld
Cyrus Luczkow
Kevin Berardino
David Wellman
Rachel Talley Bruns
Daniel Zelazny
- Publikationsdatum
- 27.06.2024
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Archives of Orthopaedic and Trauma Surgery / Ausgabe 7/2024
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916 - DOI
- https://doi.org/10.1007/s00402-024-05407-1
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