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Orthopaedics
Knee
Built from Orthopedic Trauma Essentials
What’s inside
5 sections · 86 slides
Overview
- What this topic covers
Knee dislocation
An orthopaedic emergency in which the joint is the least of the problem
- What holds the knee together
- What a knee dislocation is
- The trap: it may look normal when you see it
- 14–25%
- The nerve that gets hurt
- How well does the nerve recover?
- The artery that gets hurt
- The eight-hour clock
- Why a dislocated knee can cost the limb
- How good is this evidence?
- Checking the blood supply: routine or selective?
- The ankle-brachial pressure index
- Popliteal artery running behind the knee
- Angiography: still the reference test
- The less invasive alternatives
- When to image the artery
- Deciding who gets imaged
- Where the evidence lands on imaging
- Why the knee must be held after reduction
- External fixation: pins outside the skin
- External fixator pins anchored in the tibia
- What external fixation costs
- Splint or plaster: the simpler option
- Where the evidence lands on holding the knee
- Operate, or treat without surgery?
- Surgery versus no surgery
- Where the evidence lands on surgery
- Timing: operate now or wait?
- Early against delayed reconstruction
- What the timing evidence shows
- The staged alternative
- Two cautions in the operating theatre
- Where the evidence lands on timing
Patella fractures
Fixing the kneecap so the leg can straighten again
- The kneecap and what it does
- Why patella fractures are fixed
- Tension band wiring: the idea
- What goes wrong with K-wires
- What the comparison studies found
- The bones still knit either way
- K-wires against cannulated screws
- Where the evidence is weak
- Where the evidence lands on implant choice
- Why interest moved to plates
- What the plate studies showed
- The gap in the plate evidence
- Where the evidence lands on plates
- Fractures of the bottom tip of the kneecap
- What treatment has to achieve
- Keeping the fragment beats removing it
- Suture techniques and the head-to-head data
- Choosing for an inferior pole fracture
- Where the evidence lands on the inferior pole
Tibial plateau fractures
Where timing, soft tissues and the choice of construct are all still argued over
- What a tibial plateau fracture is
- Lateral plateau fracture on a plain radiograph
- The same injury on CT slices
- Three-dimensional reconstruction of the broken plateau
- Operate now, or in two stages?
- What the temporary fixator buys you
- The evidence behind staging
- When acute fixation is reasonable
- The staged pathway
- Where the evidence lands on timing
- The menu of fixation choices
- Circular frame against standard open fixation
- One plate or two: what was studied
- One plate or two: what was found
- Camera-assisted fixation against open surgery
- Where the evidence lands on fixation
- Why the hole has to be filled
- The early work on substitutes
- Calcium phosphate and the newer substitutes
- The comparison nobody made
- Where the evidence lands on fillers
Pulling it together
What to carry away, and what nobody has settled
- Takeaways: knee dislocation
- Takeaways: patella fractures
- Takeaways: tibial plateau fractures
- Where the evidence is thin
- References
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- Orthopedic Trauma Essentials 2026