हिंदी
–Fracture dislocation of the knee is a serious injury which
can lead to loss of limb if not treated timely–
Rohtak, August 27, 2022 :- A 39-year-old woman was wheelchair-bound and in debilitating paindue to fracture dislocation of her right knee post a road accident.Under distress and pain, the Patient visited a local hospital where post medical examination, she was given a brace. However, the Patient’s kneecontinued to cause excruciating pain.
The Patient finally approached Dr Ravi Gupta,Director of Orthopaedics (Sports Medicine), Fortis Hospital Mohali. Medical evaluation revealed that the Patienthad a serious fracture dislocation in the knee. The injuries contributing to fracture dislocation was a severely broken leg bone (tibia), two broken main ligaments of the knee (ACL and MCL) and also a postero medial corner injury of knee.In a knee fracture dislocation there can be risk of injury to the main blood vessel and nerves supplying the foot and so it is considered to be highly serious injury which if not managed properly, can lead to loss of limb.
The examination of the patient revealed that the fracture was not fit for an immediate surgery because there were blisters and excessive swelling in the surrounding skin and soft tissues. Thus the surgery was deferred till the soft tissues were healed.To accelerate the healingprocess,Dr Guptaconducted deroofing of blisters (removing ‘roof’ of the blister to expose the viable tissue beneath) and stabilized the knee with a special long knee brace.
To restore knee function and stability, the team of doctors led by Dr Guptaconducted a prolonged surgery for 4 hours in which proximal tibial fracture fixation to repair the break in the leg bone, anterior cruciate ligament fixation, medical collateral ligament repairalong with posteromedial cornerrepair on the Patient on 24th November last year.After surgery, there were delayed healing of the wound due to initial bad injury to the soft tissues so Vacuum-assisted compression (VAC) was used to enhance soft tissue healing after surgery.
Following good rehabilitation at Fortis Mohali, the Patientwas able to gradually bend her knees to full extent and was able to walk with a walker. She was discharged nearly two weeks after the surgery. Regular physiotherapy and exercises helped the Patient gain full movement and within 12 weeksof the surgery, she was allowed full weight bearing with support.The Patient has recovered fully and leading a normal life today.
Discussing the line of treatment, Dr Gupta, said,“Fracture dislocation of the knee is a complex condition and delay in medical treatment can lead to loss of limb. The early complication of soft tissue necrosis is common in suchhigh energy traumatic injuries and needs meticulous treatment by surgical/chemical debridement. Vacuum assisted compression (VAC) dressing is relatively a new technology that enhances the wound healing.The Patient has resumed her normal routine.”
