Abstract
Dislocation of the knee is a serious and potentially limb-threatening injury. Associated ligamentous injuries, fractures, and vascular and nerve injuries are common. Prompt recognition of a knee dislocation and appropriate treatment of associated injuries are necessary to minimize the complications of this severe and potentially devastating injury. Peroneal nerve injury occurs in about 28% of knee dislocations and cases of multiple ligament injury. Despite numerous advances in nerve repair techniques, the prognosis for nerve injuries following knee dislocation remains poor, with overall recovery of 40%. This chapter provides a review of current recommendations for evaluation, treatment, and management of complications associated with nerve injury in knee dislocation, as well as areas for future study to improve prognosis and treatment.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Thomsen PB, Rud B, Jensen UH. Stability and motion after traumatic dislocation of the knee. Acta Orthop Scand 1984; 55 (3): 278–283.
Montgomery TJ, Savoie FH, White JL, et al. Orthopaedic management of knee dislocations: comparison of surgical reconstruction and immobilization. Am J Knee Surg 1995; 8 (3): 97–103.
Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am 1963; 45 (5): 889–904.
Roman PD, Hopson CN, Zenni EJ. Traumatic dislocation of the knee: a report of 30 cases and literature review. Orthop Rev 1987; 16 (12): 33–40.
Jones RE, Smith EC, Bone GE. Vascular and orthopaedic complications of knee dislocation. Surg Gynecol Obstet 1979; 149: 554–558.
Shelbourne KD, Porter DA, Clingman JA, et al. Low velocity knee dislocation. Orthop Rev 1991; 20 (11): 995–1004.
Myers MH, Harvey JP Jr. Traumatic dislocation of the knee joint. J Bone Joint Surg Am 1971; 53 (1): 16–29.
Myers MH, Tillman MM, Harvey, JP. Follow-up notes on articles previously published in the Journal on Traumatic Dislocation of the Knee Joint. J Bone Joint Surg Am 1975; 57 (3): 430–433.
Sisto DJ, Warren RF: Complete knee dislocation: a follow-up study of operative treatment. Clin Orthop 1985; 198: 94–101.
Shields L, Mital M, Cave EF. Complete dislocation of the knee: experience at the Massachusetts General Hospital. J Trauma 1969; 9 (3): 192–215.
Taylor AR, Arden GP, Rainey HA. Traumatic dislocation of the knee. J Bone Joint Surg Br 1972; 54 (1): 96–102.
Siliski JM, Plancher K, Ribbans W. Traumatic dislocation of the knee: complications and results of operative and nonoperative treatment. Paper no 117 presented at: Annual Meeting Scientific Program of the American Academy of Orthopaedic Surgeons; 1989.
Malizos KN, Xenakis T, Mavrodontidis AN, et al. Knee dislocations and their management: a report of 16 cases. Acta Orthop Scand 1997; (suppl 275 ): 80–83.
Towne LC, Blazina ME, Marmor L, et al. Lateral compartment syndrome of the knee. Clin Orthop 1971; 76: 160–168.
Azar FM, Brandt JC, Phillips BB, et al. Ultra-low velocity knee dislocations. Paper no 70 presented at: the 15th Annual Meeting of the Orthopaedic Trauma Association; October 1999.
Kline DG. Operative management of major nerve lesions of the lower extremity. Surg Clin N Am 1972; 52 (5): 1247–1265.
Chaing, YH, Chang MC, Liu Y, et al. Surgical treatment for peroneal nerve palsy. Chin Med J Free China Ed 2000; 63 (8): 591–597.
Ottolenghi CE, Traversa CH. Vascular and nervous complications in injuries of the knee joint. Reconstr Surg Traumatol 1974; 14: 114–135.
Platt H. On the peripheral nerve complications of certain fractures. J Bone Joint Surg 1928; 10: 403–414.
Highet WB, Holmes W. Traction injuries to the lateral popliteal nerve and traction injuries to peripheral nerves after suture. B J Surg 1942; 30: 212–233.
Kline DG, Kim D, Midha R, et al. Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurg 1998; 89: 13–23.
Wood MB. Peroneal nerve repair, surgical results. Clin Orthop 1991; 267: 206–210.
Bateman JE. Trauma to Nerves in Limbs. Philadelphia: WB Saunders; 1962.
Seddon H. Three types of nerve injury. Brain 1943; 66: 237.
Sunderland S. Nerves and Nerve Injuries. 2nd ed. Edinburgh: Churchill Livingstone; 1978; 974.
O’Donoghue DH. Dislocation of the knee. Orthop Rev 1975; 4 (5): 19–29.
Pickett JB. Localizing peroneal nerve lesions. Am Fam Phys 1985; 31 (2): 189–196.
Cohn SL, Taylor WC. Vascular problems of the lower extremity in athletes. Clin Sports Med 1990; 9 (2): 449–470.
Morton JH, Southgate WA, Deweese JA. Arterial injuries of the extremities. Surg Gynecol Obstet 1966; 123: 611–627.
Bassett FH, Silver D. Arterial injury associated with fractures. Arch Surg 1966; 92: 13–19.
Klingensmith W, Oles P, Martinez H. Arterial injuries associated with dislocation of the knee or fracture of the lower femur. Surg Gynecol Obstet 1965; 120: 961–964.
Cone, JB. Vascular injury associated with fracture-dislocations of the lower extremity. Clin Orthop 1989; 243: 30–35.
Snyder, WH. Vascular injuries near the knee: an updated series and overview of the problem. Surgery 1982; 91: 502–506.
Ghalambor N, Vangsness T. Traumatic dislocation of the knee: a review of the literature. Bull Hosp Joint Dis 1995; 54 (1): 19–24.
Montgomery JB. Dislocation of the knee. Orthop Clin N Am 1987; 18 (1): 149–156.
Schenck RC. The dislocated knee. Instructional Course Lect 1994; 43: 127–136.
Platt H, Lond MS. Traction lesions of the external popliteal nerve. Lancet 1940; 2: 612.
Gurdjian ES, Hardy WG, Lindner W, Thomas LM. Nerve injuries in association with fractures and dislocations of long bones. Clin Orthop 1963; 27: 147–150.
Towne LC, Blazina ME, Marmor L, Lawrence JE Lateral compartment syndrome of the knee. Clin Orthop 1971; 76: 160–168.
White J. The results of traction injuries to the common peroneal nerve. J Bone Joint Surg Br 1968; 50 (2): 346–350.
Mont MA, Dellon AL, Chen F, et al. The operative treatment of peroneal nerve palsy. J Bone Joint Surg Am 1996; 78 (6): 863–869.
Demuynck M, Zuker RM. The peroneal nerve: is repair worthwhile? J Reconstr Microsurg 1987; 3(3):193–197,199.
Aldea PA, Shaw WW. Management of acute lower extremity nerve injuries. Foot Ankle 1986; 7 (2): 82–94.
Trumble TE, Vanderhooft E, Khan U Sural nerve grafting for lower extremity nerve injuries. J Orthop Trauma 1995; 9 (2): 158–163.
Dubuisson A, Kline D. Indications for peripheral nerve and brachial plexus surgery. Neurol Clin 1992; 10 (4): 935–951.
Hudson AR, Kline DG. Nerve Injuries. Philadelphia: WB Saunders; 1995.
Terranova WA, McLaughlin RE, Morgan RE An algorithm for the management of ligamentous injuries. Orthopaedics 1986; 9 (8): 1135–1140.
Wilkinson MCP, Birch R. Repair of the common peroneal nerve. J Bone Joint Surg Br 1995; 77 (3): 501–503.
Berry H, Richardson PM. Common peroneal nerve palsy: a clinical and electrophysiological review. J Neurol Neurosurg Psychiatr 1976; 39: 1162–1171.
Tomiano M, Day C, Papageorgiou C, Harner C, et al. Peroneal palsy following knee dislocation: pathoanatomy and implications for treatment. Knee Surg Sports Traumatol Arthrosc 2000; 8 (3): 163–165.
Terzis J, Faibisoff B, Williams B. The nerve gap: suture under tension vs graft. Plast Reconstr Surg 1975; 56 (2): 166–170.
Hems TEJ, Glasby MA. Comparison of different methods of repair of long peripheral nerve defects: an experimental study. Br J Plast Surg 1992; 45: 497–502.
Sedel L, Nizard RS. Nerve grafting for traction injuries of the common peroneal nerve, a report of 17 cases. J Bone Joint Surg Br 1993; 75 (5): 772–774.
Campbell WC. An operation for the correction of “drop-foot.” J Bone Joint Surg Am 1923; 5: 815–825.
Ober FR. Tendon transposition in the lower extremity. N Engl J Med 1933; 209: 52.
Watkins M, Jones B, Ryder CT, et al. Transplantation of the posterior tibial tendon. J Bone Joint Surg Am 1954; 36: 1181–1189.
Clawson DK, Seddon HJ. The late consequences of sciatic nerve injury. J Bone Joint Surg Br 1960; 42 (2): 213–225.
Cozen L. Management of foot drop in adults after permanent peroneal nerve loss. Clin Orthop 1969; 67: 151–158.
Sharrard WJW. Paralytic deformity in the lower limb. J Bone Joint Surg Br 1967; 49 (4): 743.
Lipscomb PR, Sanchez JJ. Anterior transplantation of the posterior tibial tendon for persistent palsy of the common peroneal nerve. J Bone Joint Surg Am 1961; 43 (1): 60–66.
Carayon A, Bourrel P, Bourges M. Dual transfer of the posterior tibial and flexor digitorum longus tendons for drop foot. J Bone Joint Surg Am 1967; 49 (1): 144–148.
Spreafico G, Morelli A, Cavallazzi RM, et al. Palliative surgery in irreparable lesions of the peroneal nerve. Ital J Orthop Traumatol 1985; 11 (2): 185–191.
Pinzur MS, Kett N, Trilla M. Combined anteroposterior tibial tendon transfer in posttraumatic peroneal palsy. Foot Ankle 1988; 8 (5): 271–276.
Richard BM. Interosseus transfer of tibialis posterior for common peroneal nerve palsy. J Bone Joint Surg Br 1989; 71 (5): 834–837.
Hall G. A review of drop foot corrective surgery. Lepr Rev 1977; 48: 185–192.
Srinivasan H, Mukhergee SM, Subramaniam RA. Two-tailed transfer of tibialis posterior for correction of drop foot in leprosy. J Bone Joint Surg Br 1968; 50: 623–628.
Ninkovic M, Sucur Dj, Starovic B, et al. A new approach to persistent traumatic peroneal nerve palsy. Br J Plast Surg 1994; 47: 185–189.
Turner JW, Cooper RR. Anterior transfer of the tibialis posterior through the interosseus membrane. Clin Orthop 1972; 83: 241–244.
Biesalski K, Mayer L. Die physiologische Sehnenverpflanzung. Berlin: Verlag von Julius Springer; 1916.
Milgram JE. The reconstruction of some extensor mechanisms in the extremities. Instructional Course Lect 1956; 13: 121–134.
Malaviya GN. Surgery of foot drop in leprosy by tibialis posterior transfer. Lepr J India 1981; 53: 360–368.
Grimby L, Holm K, Sjestrom L. Abnormal use of remaining motor units during locomotion in peroneal palsy. Muscle Nerve 1984; 7: 327–331.
Voight M, Sinkjaer T. Kinematic and kinetic analysis of the walking pattern in hemiplegic patients with foot-drop using a peroneal nerve stimulator. Clin Biomech 2000; 15: 340–351.
Goldspink G, Tabary C, Tabary JC, et al. Effect of denervation on adaptation of sarcomere number and muscle extensibility to functional length of muscle. J Physiol 1974; 236: 733–742.
Herbison GJ, Jaweed MM, Ditunno JF Jr. Synergistic tenotomy: effect on chronically denervated slow and fast muscles of rat. Arch Phys Med Rehabil 1975; 56: 483–487.
Kinney CL, Jaweed MM, Herbison GJ. Overwork effect on partially denervated rat soleus muscle. Arch Phys Med Rehabil 1986; 67: 286–289.
Jaweed MM, Herbison GJ, Ditunno JF Jr. Overwork-induced axonal hypertrophy in soleus nerve of rat. Arch Phys Med Rehabil 1987; 68: 706–709.
Shen N, Zhu J. Experimental study using a direct current electrical field to promote peripheral nerve regeneration. J Reconstr Microsurg 1995; 11 (3): 189–193.
Beveridge JA, Politis MJ. Use of exogenous electric current in the treatment of delayed lesions in peripheral nerves. Plast Reconstr Surg 1988; 82 (4): 573–579.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Springer Science+Business Media New York
About this chapter
Cite this chapter
Monahan, T.J. (2004). Management of Acute and Chronic Nerve Injuries. In: Fanelli, G.C. (eds) The Multiple Ligament Injured Knee. Springer, New York, NY. https://doi.org/10.1007/978-0-387-22522-7_11
Download citation
DOI: https://doi.org/10.1007/978-0-387-22522-7_11
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-2342-4
Online ISBN: 978-0-387-22522-7
eBook Packages: Springer Book Archive