Orthopedic Reviews 2010; volume 2:e7

Open posterior dislocation Initial radiographs showed a posterior disloca- tion of the , with the patella staying at the Correspondence: Mohammed Fahd Amar, Avenue of the knee with rupture level of the femoral condyles, a comminuted Beiyrouth, Lotissement Zahira, N°57G, Zohour 2, of the patellar tendon fracture of the tibial tuberosity, and a split Fes, Morocco. E-mail: [email protected] and a tibial plateau fracture depression fracture of the lateral plateau, type B3 according to AO classification (Figure 1B Key words: dislocation, fracture, knee, patellar tendon, tibial plateau. Mohammed Fahd Amar, Badr Chbani, and C). No magnetic resonance imaging (MRI) Oussama Ammoumri, Amine Marzouki, of the knee was performed. The patient was Contributions: all authors have contributed to taken to the operating room, where the knee Fawzi Boutayeb and read the article, and have given permission dislocation was reduced under regional anes- for their names to be included as co-authors. Department of Orthopedic Surgery A, UH thesia. After debridement, the exploration of Hassan II, Fes, Morocco the right knee found a rupture of the patellar Conflict of interest: the authors confirm that the tendon from its tibial insertion, with a com- manuscript has not been published nor submit- ted simultaneously elsewhere, and that there are minuted fracture of the tibial tuberosity, and a no conflicts of interest associated with this paper. split depression of the lateral plateau. The fix- Abstract ation of the lateral plateau fracture was accom- Received for publication: 1 December 2009. plished with two lag screws inserted under Revision received: 9 February 2010. Knee dislocations are rare injuries. They radiographic guidance, and the patellar tendon Accepted for publication: 9 February 2010. represent a severe soft tissue injury following was repaired and reattached to the tibial high-energy blunt trauma. We report a case of tuberosity by transosseous sutures and pro- This work is licensed under a Creative Commons open posterior knee dislocation with rupture of tected by a patellotibial cerclage (Figure 2). Attribution 3.0 License (by-nc 3.0). the patellar tendon and a fracture of the tibial Postoperatively, a posterior plaster splint was ©Copyright M.F. Amar et al., 2010 plateau. The treatment was surgical and con- applied with the knee in 15° of flexion. The Licensee PAGEPress, Italy sisted of reduction of the knee dislocation, fix- patient was instructed to do quadriceps Orthopedic Reviews 2010; 2:e7 ation of the tibial plateau fracture by lag strengthening exercises. The plaster splint doi:10.4081/or.2010.e7 screws, and transosseous sutures for the patel- was removed at six weeks after surgery, and lar tendon protected by a patellotibial cerclage. knee mobilization was started. The range of The result was successful with full range of motion gradually increased. Two weeks after- bicruciate injury with either the posteromedial motion. ward, the patient was able to extend the knee or the posterolateral corner intact and the actively from 80° of flexion. At this time, the other torn. Knee dislocation IV is an injury to patellotibial cerclage was removed (Figure 3), both cruciate as well as both their and knee mobilization under general anesthe- corners. Knee dislocation V is a knee disloca- Introduction sia was accomplished; 120° of flexion was tion associated with a periarticular fracture. achieved by the end of the knee mobilization. Our case is unclassifiable according to the Knee dislocations are uncommon injuries The knee was stable, with integrity of all knee modified Schenck’s classification. Subgroups with a wide variety of presentations and treat- ligaments. Then the patient was sent for phys- defining status of the patellar tendon and com- ment options. They are caused by violent trau- ical therapy. He returned two years after sur- bination of injuries may be added to the classi- ma. Damage t