Neglected knee dislocations are rare. There is no agreement on the best treatment for these injuries. In this report, we present a case of Old knee dislocation treated with open reduction and proximal tibial traction pin. After open reduction and extensive soft-tissue release, the complete reduction was not achieved. Therefore, we used a proximal tibial traction pin to gradually obtain a complete reduction via ‎traction weight change.‎ We did no ligamentous repair. One year after the operation, the patient had an acceptable radiographic reduction and satisfactory clinical outcomes. We recommend the proximal tibial traction pin as a valuable alternative in the treatment of neglected ‎knee dislocation. In addition to its promising outcomes, the traction pin is much less expensive than the already-used devices. Moreover, the introduced procedure makes the future conversion to total knee arthroplasty (TKA) more feasible, which is considered a significant concern in such ‎patients.

Background: knee dislocations are uncommon (<0. 5% of all dislocations); however, they may result in catastrophic outcomes secondary to their high‑ energy nature and neurovascular injuries. Objectives: The objective of this study was to evaluate the clinical outcome of knee dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with knee dislocation were enrolled in this cross‑ sectional study between 2011 and 2014. A single knee surgeon examined all the patients for knee instability for subjective evaluation of knee function using the Lysholm knee Questionnaire, knee Society Score (KSS), and Short Form‑ 36 (SF‑ 36). Results: The average Lysholm knee Scores and KSS were 68 (range: 18– 100) and 65 (range: 15– 97), respectively. All domains of SF‑ 36 among the studied patients were lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma and operation with outcome variables (Lysholm knee Score, KSS, and SF‑ 36 Physical Component Score, and SF‑ 36 Mental Component Score). Conclusions: The knee function after proper management of dislocation is reasonable, but prolonged course of management and multiple operations may decrease the patients’ quality of life.

Tibiotalar dislocation without concomitant fracture in the surrounding bones is a rare injury. We report one of them presenting unreduced after a 10 month interval. A 23 y/o female presented to our clinic 10 months after Bam earthquake, during which she had sustained an anterior tibiotalar dislocation without any associated fracture. Open reduction was tried two times, but both attempts were unsuccessful because of the very poor quality of bone. Although ankle dislocation has been reported to be associated with good prognosis, it was not the case with our late presenting patient.

Background and Aim: Traumatic knee dislocation is an uncommon injury that may be limb threatening.  Ligamentus, nerve and vascular Injury are complication of it. Popliteal vessele Injury is important complication. Historically, arteriography has been used routinely in patients with knee dislocations. The goal of this study: is artriography always necessary?Materials and Methods: We conducted an institutional retrospective review of patients admitted at a university trauma center with knee dislocations from Feb. 2006, to feb.2007. Eighteen patients (16 male and 2 female; average age, 28 years) had 18 dislocations (10 left and 8 right, 17 posterior and 1 latral). Most patients (n=12) were involved in motor vehicle crashes. Seven patients underwent arteriography.Results: All patients had ligamentus injury (in order to PCL, ACL, LCL). 8 patients had popliteal vessel injury. Physical examination in 9 patients was normal so angiography didn’t do. In other 9 patients physical examination were abnormal, two of them undergo early BK amputation without angiography. Six patients with abnormal angiogram 6 patients undergo vascular surgery. The other one had normal angiography in spite of abnormal physical examination.Conclusion: The common complication in knee dislocation is ligamentous injury otherwise the important is vascular damage, and it seems that routine arteriography is not necessary in patients with a normal PE after reduction of the knee dislocation.

Volar radioulnar dislocation without fracture in ulna or radius is rare. This is a report of and Old volar dislocation of distal ulna that required open reduction and ligament reconstruction with free tendon graft.

Congenital dislocation of the knee ranges from hyperextension of the knee to complete translation of the femur on the tibia. Treatment is usually started in very early infancy. In this report, a 16-year-Old girl presented with a grade III untreated congenital dislocation of the knee. She received surgical treatment at this late age, and managed to stand upright and walk.

Background: With respect to various therapeutic outcomes achieved in the treatment of patients with knee dislocation, the present study was performed with the aim of determining the epidemiology and therapeutic outcomes of knee dislocation in patients referring to Taleghani hospital, 1989-2001.Materials and methods: It was an existing data type study. Initial data including personal characteristics, therapeutic approach, period of follow up, and therapeutic outcomes were all recorded.Results: Between 1989 and 2001, 25 patients have been referred to Taleghani hospital with the diagnosis of knee dislocation. The study population included 24 males and 1 female with the mean age of 35±13 years. Vehicles in 60% of the cases caused trauma. knee dislocation was reduced within 5 hours in 25% of the patients. 12 (48%) had popliteal artery injury, of which 7 (58%) required vein graft and 3 (25%) led to amputation. 12 (48%) were treated by prompt reduction and splitting. Reduction, ligament reconstruction and meniscal repair were performed by orthopedic surgeon in 16 (64%).Transient proneal nerve injury was reported in 7 (36%) patients, of which 2 (28%) were recovered within 5±3 months. Proneal nerve injury was accompanied by fracture of femur and tibia in 48% of the patients. Posterior knee dislocation was seen in 8 (32%) patients. 5 cases were presented with simultaneous occurrence of floating knee and ipsilateral knee dislocation. Radiography had detected dislocation in 20 (80%) cases, however, autobiography and surgical exploration had revealed arterial injuries in 36% of the cases. 88% of the patients had maintained mean range of motion of 104±4.7 degree. The limb salvage success rate was 88% with the 12% remaining limbs required amputation.Conclusion: The reported incidence of knee dislocation was a little bit higher than previous studies. Motor vehicle accidents were the most common cause of knee dislocation. Immediate diagnosis and reduction as well as accurate follow up are of utmost importance.

Background: There are not many reports regarding the treatment approaches of congenital dislocation of the knee in the literature. Therefore, the preferred method of treatment of this rare congenital disease is still controversial. Hereby, we report the treatment outcome of 29 patients admitted in Shafa Yahyaian Hospital during 40 years.Methods: In this retrospective study done in Shafa Yahyaian Hospital in Tehran, Iran during 2010, we retrospectively reviewed the medical records of 29 patients treated conservatively or surgically for congenital dislocation of the knee. Patients had been evaluated for an average follow-up of 8.5 years.Results: Overall, 54 knee dislocations had been treated surgically (58%) or conservatively (42%). Range of knee motion, persistent recurvatum, instability, valgus deformity after treatment and limping were the more important factors reported in the two surgically or conservatively treated groups. knee function was satisfactory in patients with conservative treatment. Despite 80% of instability in the operated knees, patients could ambulate with or without braces and had a range of motion equal to 80 degrees. knee function was also good after quadricepsplasty with transarticular pins in selected cases.Conclusion: We recommend a conservative approach to the disease, regardless of the patient’s age at the time of treatment and subsequent surgery in patients with dissatisfactory recovery. Quadricepsplasty with transarticular fixation is recommended as a good option in treating these patients. Posterior capsulorrhaphy for patients with CDK and ligamentous laxity is also recommended.

Background: Perilunate dislocation and fracture-dislocation are rare injuries. Treatment of these injuries can be more challenging in Old and neglected cases. In this study we report the outcomes of a two-stage treatment of Old and neglected cases of these injuries by applying a distracting external fixator (first stage) and open reduction 3-4 weeks later (second stage). Methods: In this retrospective study, seven patients who underwent the two-stage treatment were included. Outcome measurements included Visual Analogue Scale (VAS) for pain, functional evaluation of the wrist by Disabilities of the Arm, Shoulder, and Hand (DASH), power and pinch grip assessment, radiocarpal range of motion and arthrosis in the radiocarpal and mid carpal joints. Results: Mean time interval between the injury and surgery was 7± 4. 9 months. Mean follow up period was 16. 8± 10. 7 months. Grip strength of the injured hand was 82. 1% of the contralateral hand. Pinch strength of the involved hand was 82. 5% of the contralateral hand. Range of motion in the radiocarpal joint of the injured hand was 49. 6% in flexion/extension and 64. 6% in ulnar/radial deviation of the uninjured hand, respectively. Mean VAS and DASH score were 4. 1 and 28. 5, respectively. Scaphoid nonunion was seen in one patient and radiocarpal joint arthrosis occurred in another one. Conclusion: According to the acceptable result of this study, we recommend twostage treatment for the management of Old perilunate injuries.