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      Bilateral knee dislocation with associated bilateral popliteal arterial injury Translated title: Luxação bilateral dos joelhos com lesão bilateral da artéria poplítea

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          Abstract

          Tibiofemoral unilateral knee dislocations are uncommon, making bilateral dislocations even rarer injuries. Knee dislocation is considered one of the most serious injuries that can affect this joint. Associated complications such as popliteal artery injury are responsible for the important morbidity in these patients. The authors report the case of a 52-year-old man with a traumatic bilateral knee dislocation with associated bilateral popliteal arterial injury. His clinical presentation along with radiographic and angiographic findings are described. Surgical and non-surgical treatment and functional outcomes are also reported.

          Resumo

          As luxações unilaterais tibiofemurais do joelho são incomuns, o que torna as luxações bilaterais ainda mais raras. A luxação do joelho é considerada um dos ferimentos mais graves nesta articulação. As complicações associadas, tais como a lesão da artéria poplítea, são responsáveis pela importante morbidade observada nesses pacientes. Os autores relatam o caso de um homem de 52 anos com luxação traumática bilateral do joelho associada a lesão bilateral da artéria políptea. O estudo descreve a apresentação clínica e os achados radiográficos e angiográficos. O tratamento cirúrgico e não-cirúrgico e os resultados funcionais também são relatados.

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          Most cited references11

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          Vascular injuries associated with dislocation of the knee.

          Two hundred and forty-five knee dislocations were analyzed including forty-one new cases. The high incidence of injuries to the popliteal artery that accompanies this lesion (32 per cent) was confirmed, and it was re-emphasized that vascular repair must be completed within six or at the most eight hours from the time of injury to avoid amputation. Of the patients not treated within that time period, 86 per cent had an amputation and two-thirds of the remaining 14 per cent had ischemic changes.
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            Vascular and nerve injury after knee dislocation: a systematic review.

            Vascular injury is a devastating complication of acute knee dislocation. However, there are wide discrepancies in the reported frequency of vascular injury after knee dislocations, as well as important differences among approaches for diagnosis of this potentially limb-threatening problem.
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              Knee dislocation: initial assessment and implications for treatment.

              To evaluate bicruciate knee injuries and determine whether they should be treated as knee dislocations, especially with regard to vascular injuries. Retrospective. University hospital, level 1 trauma center. Fifty patients admitted between 1987 and 1994 who had sustained knee dislocations or bicruciate ligament injuries. Mechanism of injury, direction of dislocation, knee ligament injury pattern, presence or absence of periarticular fracture, presence of vascular and nerve injuries, and location of associated trauma were measured. Twenty-two knees had classic knee dislocations. Twenty-eight knees presented as "reduced" bicruciate ligament injuries. Vascular injury occurred just as frequently in bicruciate ligament injuries as in knee dislocations. The direction of the knee dislocation did not predict ligament injury pattern or the presence of arterial injury. Bicruciate ligament injuries are equivalent to knee dislocations with regard to mechanism of injury, severity of ligamentous injury, and frequency of major arterial injuries.
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                Author and article information

                Contributors
                Journal
                Rev Bras Ortop
                Rev Bras Ortop
                Revista Brasileira de Ortopedia
                Elsevier
                2255-4971
                18 March 2017
                Mar-Apr 2018
                18 March 2017
                : 53
                : 2
                : 248-251
                Affiliations
                [a ]Coimbra Hospital and University Centre, Orthopedics Department, Coimbra, Portugal
                [b ]Coimbra Hospital and University Centre, Sports Medicine Department, Coimbra, Portugal
                [c ]Coimbra Hospital and University Centre, Vascular Surgery Department, Coimbra, Portugal
                Author notes
                [* ] Corresponding author. dflmoura@ 123456gmail.com
                Article
                S2255-4971(17)30035-6
                10.1016/j.rboe.2017.03.010
                6001151
                947384d9-8ae0-445d-a6a5-11ccf8f3a23b
                © 2017 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 November 2016
                : 17 January 2017
                Categories
                Case Report

                knee injuries,femoral fractures,dislocations,popliteal arterial,lesões do joelho,fratura do fêmur,luxações,artéria poplítea

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