Complicated knee fractures

The knee is a commonly injured joint.  One or more bones around the knee may be fractured, often in multiple pieces. Common mechanism of knee fractures is fall from a scooter. . The fracture is more serious if broken bone involves the joint because if not treated properly, the knee in such cases becomes deformed and stiff. Essentially, most fractures around the knee are to be meticulously fixed by surgery so that the knee can be moved as early as possible. Accurate re-positioning of the fracture fragments and stable fixation of these fragments is key to achieving good results in these cases. Experience, facilities in the OT and availability a variety of implants is critical in doing these operations well.

We have expertise of treating these fractures fresh or old.  Often these fractures need to be opened by more than one incision. Often the incisions required are at the back of the knee, and area susceptible to complications as the nerves and blood vessels supplying the leg lie in this area.

Some examples of these fractures treated by us are as below:

This 30 year old lady was referred  to us from Bihar (700 Km away).  She sustained a complex fracture of knee – fracture of upper tibia with dislocation of the knee. The seriousness of the injury could not be comprehended by the first treating surgeon, and she was treated in plaster cast.  At removal of plaster, she realized that she could not walk.  X-ray showed that her knee was subluxated. This happened because the injury was a combination of fracture plus ligament injury.

We took her up for surgery which involved 4 hour of operation.  She has to be opened up from back of the knee and also from front.  Ultimately the knee was put in proper shape.  It took her 6 months to get back to her feet.  Today she walks like a normal person.

Before surgery x-ray showing that knee bones are not in proper alignment

X-ray showing that the leg bone is not properly aligned

The lady could not bend the knee

She could walk on bent knee with great difficulty, a limp and pain

X-ray after surgery showing a combination of surgery done – ligament reconstrction with reconstruction of the bone. This lead to the joint coming back to proper alignment.

Sabe being confirmed with another projection of the x-ray

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is a rather uncommon complex knee injury. We have recently reported this injury in Journal of Indian Orthopaedic Association.