Knee dislocations and associated fractures: risk factors for surgical reduction

被引:0
作者
Koltenyuk, Victor [1 ]
Merckling, Matthew [1 ]
Grunfeld, Matan [1 ]
Luczkow, Cyrus [1 ]
Berardino, Kevin [2 ]
Wellman, David [2 ]
Bruns, Rachel Talley [2 ]
Zelazny, Daniel [2 ]
机构
[1] New York Med Coll, Sch Med, 40 Sunshine Cottage Rd, Valhalla, NY 10595 USA
[2] New York Med Coll, Westchester Med Ctr, Dept Orthoped Surg, Valhalla, NY USA
关键词
Knee dislocation; Surgical reduction; Tibia fracture; Fibula fracture; INJURY; MANAGEMENT;
D O I
10.1007/s00402-024-05407-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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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页码:3011 / 3015
页数:5
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