Shin dislocation: causes, symptoms, diagnosis, treatment

ICD-10 code

S83.1. Dislocation of the knee joint.

Epidemiology of leg dislocation

Dislocations of the tibia account for 1-1.5% of the total number of dislocations.

[1], [2], [3], [4], [5], [6]

What causes a shin dislocation?

They arise as a result of a direct and indirect injury mechanism when exposed to a significant mechanical force. In order for the joint surfaces of the thigh and lower leg to disengage, all or almost all ligaments of the knee joint must be ruptured. When the shin is dislocated, the meniscus is damaged, and sometimes the vascular bundle is also damaged.

Symptoms of leg dislocation

Recognition of shin dislocations is not very difficult. The lower extremity is bayonet-shaped at the level of the knee joint. The latter is deformed, the abnormally located condyles of the thigh and lower leg are probed. The knee joint is unstable. Active movement in it is impossible. The limb is shortened.

It is necessary to check pulsation on the arteries of the feet and innervation of the lower leg and foot.

Classification of leg dislocation

Depending on the dislocation of the lower leg, as a result of trauma, we distinguish the posterior, anterior, external, internal dislocations. The rear dislocations of the lower leg are more common.

[7], [8], [9], [10], [11]

Complications of leg dislocation

Complications of shin dislocation can be damage to the peroneal nerve, popliteal arteries and veins.

[12]

Diagnosis of leg dislocation

On the roentgenogram determine the dislocation of the shank in one direction or another.

[13], [14], [15]

Treatment of leg dislocation

Conservative treatment of leg dislocation

An urgent elimination of dislocation under general or local anesthesia is indicated. The patient is placed on his back. The assistant fixes the thigh of the patient, and the surgeon makes traction for the shin bent at the knee joint. After extension, the proximal part of the tibia is moved back to the displacement, the limb is straightened to an angle of 5-10 °. Dot the knee joint and remove the contents.

Apply a circular gypsum dressing from the upper third of the thigh to the ends of the fingers for a period of 8-10 weeks. From the 3rd day, assign UHF, LFK static type. After 7-10 days they are allowed to walk on crutches. After the removal of immobilization, the patient is prescribed physiotherapeutic procedures, exercise therapy of active and passive types, hydrotherapy, but he should continue to walk on crutches without loading the leg for another 3-4 weeks.

Surgical treatment of leg dislocation

With the remaining instability of the knee, you should achieve the maximum possible volume of movements and then determine the timing of the plasty of damaged cruciform or collateral ligaments.

Estimated period of incapacity for work

Workability is restored in 3,5-4 months.

[16]