Medial or lateral collateral complex injury common
Vascular vulnerability
Popliteal artery tethered proximally and distally
Intimal injury leading to delayed thrombosis
Nerve vulnerability
Common peroneal nerve stretch injury
Persistent foot drop risk
Therapeutic Considerations
Time dependence
Early reduction improves perfusion and skin outcomes
Class I recommendation based on expert consensus for immediate reduction of dislocated knee
Imaging not a prerequisite for reduction when limb threatened
Vascular screening after reduction
ABI based pathway reduces missed arterial injury risk
Serial exams required due to delayed thrombosis possibility
Multidisciplinary care
Orthopedics for stabilization planning
Vascular surgery for injury management
Rehab planning for nerve deficits
Patient Discharge Instructions
copy discharge instructions
Home care and protection
Knee immobilizer or splint at all times
Keep clean and dry
Do not remove unless instructed
Non weight bearing
Use crutches or walker
No driving until cleared
Pain control
Acetaminophen dosing per weight and label instructions
Max daily dose per age and liver status
Avoid duplicate acetaminophen products
NSAID use only if cleared by treating team
Bleeding risk and fracture considerations
Kidney disease avoidance
Return immediately to ED
New or worsening numbness
Tingling in foot
Loss of sensation
New weakness
Foot drop
Inability to move toes
Color or temperature change
Pale or blue foot
Cold foot
Worsening pain not controlled
Pain out of proportion
Severe pain with toe or ankle movement
Increasing swelling or tightness in calf
Severe pain with passive stretch
Tense compartments
Fever or wound drainage if open injury
Redness spreading
Foul discharge
Follow up plan
Orthopedics appointment timing per discharge plan
Bring imaging reports
Discuss ligament injury plan
Vascular follow up if advised
Repeat vascular testing plan
Monitor pulses at home if instructed
References
Guidelines and evidence sources
Core trauma references
ATLS principles for limb threatening injuries
Immediate reduction when neurovascular compromise
Time critical transfer for definitive care
Orthopedic trauma references on knee dislocation algorithms
Routine vascular screening after reduction
Multiligament injury management pathways
Vascular evaluation evidence
ABI based screening strategy after knee dislocation
ABI threshold 0.9 used in common algorithms
Serial neurovascular exams due to delayed thrombosis risk
CTA as confirmatory imaging when screening abnormal
Identifies intimal injury and occlusion
Guides operative versus endovascular planning
Recommendation framework statements
Class I recommendation based on expert consensus for immediate reduction with suspected neurovascular compromise
Reduction prioritized over imaging when limb threatened
Reassessment and definitive vascular evaluation after reduction
Class I recommendation based on expert consensus for emergent vascular surgery involvement with hard signs or abnormal post reduction ABI
Rapid imaging or operative exploration based on resources
Compartment syndrome surveillance after reperfusion
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