Knee Dislocations

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Evaluate the limb´s pallor, nailbed and pulse before reduction (any difference between the other side limb is also a positive sign of associated problems with a dislocation). Also is important to evaluate limb´sensivity before reduction. Reevaluate all 5 minutes after reduction. During reduction beware of a cracking noise (not the pop noise- reduction). Sometimes the dislocation comes with a fracture. There is no way to rule out a fracture without a an X-ray. So there could be a risk for legal problem. Patients sometimes blame the practitioner as the culprit of the fracture.
There will be a normal color after a right reduction and the pain will be almost gone. In the case that you can´t find any change then prove the movements of the dislocated articulation. If there is no reduction or there is a dislocation-fracture the movements will be Cleary diminish and very painful. 
For a knee the reduction is easy and with axial traction it will do. A knee should be quickly reduced because a vascular lesion could appear  

Reference: this is an ortho book online http://www.wheelessonline.com/

Regards
Dr. Manuel Sotelo
Caracas
 

Reduction of any dislocation is in order as the dislocation might be  
impinging on a vessel or nerve.   Reducing the dislocation takes  pressure off 
the impingment and can be beneficial.   
 
k
 
 
In a message dated 6/15/2010 11:15:40 A.M. Central Daylight Time,  
pbjorn at emh.org writes:

Recommendations for rural management?  Is it safe for the  local EM
provider to reduce on site; or are operative/angiographic backup  a
prerequisite?

References appreciated.  I'm coming up short  with PubMed and Google
Scholar.

Pret Bjorn, RN
Bangor, ME  USA

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