[Effectiveness of traumatic dislocation of knee joint combined with multiple ligament injuries treated by stages].

Objective: To observe the effectiveness of traumatic dislocation of the knee joint combined with multiple ligament injuries treated by stages.

Methods: Between june 2005 and November 2008, 13 cases of traumatic dislocation of the knee joint combined with multiple ligament injuries were treated by stages, including 9 males and 4 females with an average age of 30.7 years (range, 18-54 years). The dislocations were left knee in 3 cases and right knee in 10 cases. The causes of injury were sports injury in 8 cases, traffic accident injury in 2 cases, falling from height injury in 2 cases, and sprain injury in 1 case. The average time from injury to hospitalization was 9 hours (range, 6 hours to 2 days). Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial collateral ligament (MCL) were involved in 8 cases; ACL, PCL, and lateral collateral ligament (LCL) in 3 cases; and ACL, PCL, MCL, and LCL in 2 cases. The valgus stress testing results of 10 knees were ++ to +++; the varus stress testing results of 5 knees were ++ to +++; all knees showed positive in the anterior or the posterior drawer test and ++ to +++ in Lachman test. The nerve, vessel, MCL, LCL, PCL, meniscus were repaired in the first operation. The functional exercise of knee joint was done after fixation for 3-4 weeks. During the second operation, the ACL was reconstructed under arthroscopy after the range of motion (ROM) of knee joint was good with anterior instability of knee within 4-6 months.

Results: All wounds healed by first intention after two operations; no complications of infection and compartment syndrome occurred. All cases were followed up 12-60 months with an average of 36 months. Joint effusion of knee occurred in 2 cases at 4 weeks after the first operation and was cured after removal of fluid. At 3 months after the second operation, the results of valgus stress testing and Lachman test were ++ in 1 case, respectively; the results of valgus stress testing, varus stress testing, and Lachman test were + in 1 case, respectively; and others showed negative results. After 12 months of the second operation, the mean flexion of the knee was 123.4 degrees (range, 100-135 degrees), and the mean extension of the knee was 2.3 degrees (range, 0-4 degrees). According to Lysholm evaluation system, 9 patients got excellent results, 2 good, and 2 fair; the excellent and good rate was 84.6%.

Conclusion: It is an effective method in the treatment of traumatic dislocation of the knee joint combined with multiple ligament injuries by stages.