scholarly journals Triple dislocation around the knee joint: a case report

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Ernest Chew ◽  
Aadhar Sharma ◽  
Chinmay Gupte
Keyword(s):  
Knee Joint ◽  
Popliteal Artery ◽  
Peroneal Nerve ◽  
Knee Injuries ◽  
Common Peroneal Nerve ◽  
Current Evidence ◽  
Main Concern ◽  
Trauma Patients ◽  
Close Monitoring ◽  
Plain Films

Abstract Background Dislocation of the knee is a serious and potentially limb-threatening injury. There are three types of dislocation around the knee joint: patellofemoral, tibiofemoral, and tibiofibular. Tibiofemoral dislocation is the variant that is deemed the most serious, with a higher risk of compromise to the popliteal artery and common peroneal nerve. Although simultaneous dislocations of two types have been described, there has been no such description of all three types occurring simultaneously. Case presentation We present a case of a 40-year-old hairdresser who suffered a fall off her moped in Spain, and simultaneously dislocated all three articulations around the knee. Diagnosis was achieved with clinical examination, plain films, and computed tomography and magnetic resonance imaging scans. Management consisted of initial surgical debridement and reduction with stabilization of the affected joints. Conclusion Dislocation of the knee is an uncommon but life changing and potentially limb-threatening injury. It should always be suspected in trauma patients who present with multiligamentous knee injuries. The main concern is of neurovascular compromise to the lower leg, namely, the popliteal artery and common peroneal nerve. The treatment of multiligamentous knee injuries for most patients is surgical treatment with physiotherapy and adequate stabilization of the knee joint. Close monitoring of progress of the knee in terms of persistent laxity, range of movement, and functional status is required for at least 1-year post injury. Current evidence suggests that, despite good functional outcomes for knee dislocations in the short term, the prevalence of post-traumatic osteoarthritis is high in the long term.

scholarly journals When size does not matter: a rare case of popliteal artery aneurysm presenting with foot drop and its endovascular management

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Jeong-moh J Yahng ◽  
Lei Ying
Keyword(s):  
Popliteal Artery ◽  
Peroneal Nerve ◽  
Rare Case ◽  
Common Peroneal Nerve ◽  
Nerve Compression ◽  
Foot Drop ◽  
Arterial Aneurysm ◽  
Popliteal Aneurysm ◽  
Acute Limb Ischaemia ◽  
Adjacent Structures

Abstract Popliteal artery aneurysms (PAA) are the commonest arterial aneurysm of the periphery. It is defined as focal dilation more than 50% of the normal vessel diameter, which usually varies between 7 and 11 mm. The most common presentation for PAA is claudication due to luminal stenosis caused by mural thrombus or acute limb ischaemia due to thromboembolism. It is much less common for patients to present with mass effect symptoms due to compression of adjacent structures, and of these, common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA measuring 22 × 21 mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option used.

Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case

Vascular ◽  
2020 ◽  
pp. 170853812095087
Author(s):  
Tiehao Wang ◽  
Jichun Zhao ◽  
Ding Yuan
Keyword(s):  
Popliteal Artery ◽  
Peroneal Nerve ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Artery Aneurysm ◽  
Common Peroneal Nerve ◽  
Glucocorticoid Therapy ◽  
Foot Drop ◽  
Open Surgical Repair ◽  
Popliteal Artery Aneurysm

Objectives Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies. Methods We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively. Results The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac. Conclusions Our modified open surgical repair can relieve the compression and prevent possible “type II endoleak” without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.

Neurologic and Vascular Injuries Associated with Knee Ligament Injuries

2008 ◽  
Vol 36 (12) ◽  
pp. 2448-2462 ◽  
Author(s):  
Michael E. Johnson ◽  
Lynanne Foster ◽  
Jesse C. DeLee
Keyword(s):  
Patient Outcomes ◽  
Popliteal Artery ◽  
Tibial Nerve ◽  
Knee Injuries ◽  
Vascular Complications ◽  
Common Peroneal Nerve ◽  
Nerve Injuries ◽  
Ligament Injuries ◽  
Knee Ligament ◽  
Knee Ligament Injuries

Background Multiple ligament knee injuries are commonly associated with neurovascular complications such as popliteal artery, common peroneal nerve, and tibial nerve injuries. Hypothesis While the importance of identifying these complications in association with bicruciate and triligamentous injuries has been well established, it is important to recognize that any biligamentous and some single ligament knee injuries present with neurological and vascular complications as well. Study Design Literature review. Conclusion Popliteal artery injuries require immediate intervention to help prevent limb loss. Peroneal and tibial nerve injuries can be a significant cause of morbidity and, therefore, require an understanding of their natural history, anatomy, and pathophysiologic implications to maximize functionality. Clinical Relevance This review explores the types, mechanisms, and classifications of common neurovascular complications of knee ligament injuries, discusses their diagnosis, and reviews the therapeutic options available to optimize patient outcomes.

scholarly journals Prognostic factors in patients who underwent surgery for common peroneal nerve injury：a nest case-control study

2021 ◽  
Author(s):  
Zhenhui Liu ◽  
Maimaiaili Yushan ◽  
Yanshi Liu ◽  
Aihemaitijiang Yusufu
Keyword(s):  
Knee Joint ◽  
Functional Recovery ◽  
Peroneal Nerve ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Common Peroneal Nerve ◽  
Joint Dislocation ◽  
Proximal Fibula ◽  
Plateau Fracture ◽  
Postoperative Knee

Abstract Background：Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients’ prognosis. Methods：This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results：The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR=3.35), occupation(“blue trouser” worker vs “white-trouser” worker, OR=4.39), diabetes (OR=11.68), cardiovascular disease (OR=51.35), knee joint dislocation (OR=14.91), proximal fibula fracture (OR=3.32), tibial plateau fracture (OR=9.21), vascular injury (OR=5.37) and hip arthroplasty (OR=75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR=0.18) and postoperative knee joint immobilization (OR=0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863-0.946.Conclusions：Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factor of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.

scholarly journals Common Peroneal Nerve Palsy after Retrograde Popliteal Artery Puncture

2002 ◽  
Vol 23 (5) ◽  
pp. 467-469 ◽  
Author(s):  
S. Yılmaz ◽  
H. Altınbaş ◽  
U. Şenol ◽  
T. Sindel ◽  
A. Mete ◽  
...  
Keyword(s):  
Popliteal Artery ◽  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Palsy ◽  
Common Peroneal Nerve Palsy

scholarly journals Analysis of Prognostic Risk Factors for Operative Common Peroneal Nerve: A Nest Case-Control Study

2020 ◽  
Author(s):  
Zhenhui Liu ◽  
Maimaiaili Yushan ◽  
Yanshi Liu ◽  
Aihemaitijiang Yusufu
Keyword(s):  
Knee Joint ◽  
Functional Recovery ◽  
Peroneal Nerve ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Common Peroneal Nerve ◽  
Joint Dislocation ◽  
Proximal Fibula ◽  
Plateau Fracture ◽  
Postoperative Knee

Abstract Background Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the factors associated with the neural recovery of injured CPN in patients undergoing surgical exploration of CPN.Methods This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to assess which explanatory variables are associated with recovery of neurological function. We used multivariable logistic regression analysis to determine variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results There were 67 patients divided into case group and 320 patients divided into control group. In multivariate logistic regression analysis, we found that city area (OR = 3.35), labor occupation (OR = 4.39), diabetes (OR = 11.68), cardiovascular disease (OR = 51.35), knee joint dislocation (OR = 14.91), proximal fibula fracture (OR = 3.32), tibial plateau fracture (OR = 9.21), vascular injury (OR = 5.37) and hip arthroplasty (OR = 75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR = 0.18) and postoperative knee joint immobilization (OR = 0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863–0.946.Conclusions City area, labor occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factor of motor functional recovery of injured CPN. The prediction nomogram can be used to predict the prognosis of injured CPN.

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