Acute multiligament injured or dislocated knee: field assessment and management

Knee dislocation is a serious but uncommon injury that can result in significant trauma to the ligaments, nerves, and blood vessels of the leg. With a high rate of spontaneous reduction and signs of injury that are often subtle in the acute stage, knee dislocation can be missed if not specifically sought through meticulous and thorough history-taking and physical examination. Targeted visual inspection, neurologic and vascular examination, and palpation of the limb are all instrumental in the identification of a potential multiligament knee injury or dislocated knee. The association of significant vascular injury with knee dislocation puts the injury victim at risk of limb loss if the injury is not identified and treated in a timely fashion. By identifying the injury, reducing and splinting as appropriate, and communicating awareness of the injury to hospital-based caregivers, the paramedic has a unique opportunity to direct the course of treatment that the patient receives.