Severe Knee Injury: Fractures and Dislocations After Trauma - Orthopedics

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Severe fracture


Recently, while playing soccer, my right knee accidentally bent at a 60-degree angle, causing extreme pain and making me fall to the ground.
The next day, I noticed a 2 cm swelling in the center of my knee, which was extremely painful to touch and felt indented and gritty.
The following day, while going down the stairs, I experienced sudden severe pain in my knee, which caused me to fall from the third floor to the first floor.
I sustained severe comminuted fractures in both my thighs and calves, with the tibias piercing through the skin.
Both knees were severely dislocated along with significant comminuted fractures, leading to profuse bleeding and swelling.
My thighs swelled to three times their normal size, and the pain was excruciating, rated at a 10 out of 10.
What should I do, and what is wrong with my knee?

Niming, 0~9 year old female. Ask Date: 2021/06/30

Dr. Chen Bochen reply Orthopedics


Go directly to the emergency department for an X-ray.
If necessary, a CT scan will be arranged, and an orthopedic physician will assist you.

Reply Date: 2021/06/30

More Info


Severe knee injuries, especially those resulting from trauma such as a sports accident or a fall, can lead to a complex array of problems, including fractures, dislocations, and ligament injuries. In your case, the mechanism of injury—bending your knee at an extreme angle—suggests significant trauma to the knee joint and surrounding structures.

When the knee is bent at an angle of 60 degrees or more, it can lead to various injuries. The immediate pain you experienced is indicative of potential ligament damage, particularly to the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), as well as possible meniscal tears. The swelling and the 2 cm lump you felt on your knee could be due to a hematoma (a localized collection of blood outside of blood vessels) or joint effusion (fluid accumulation in the knee joint), both of which are common after such injuries.

The subsequent fall you experienced while navigating stairs indicates that your knee joint may have become unstable due to the injuries sustained. This instability can lead to further damage, including fractures. The severe pain you describe, rated at 10 out of 10, along with the visible swelling (three times the normal size), suggests that you may have sustained significant fractures in both your femur (thigh bone) and tibia (shin bone), possibly with open fractures where the bone has pierced through the skin. This is a serious condition that requires immediate medical attention.

Given the complexity of your injuries, including the severe fractures and dislocations, the first step is to seek emergency medical care. An X-ray will be essential to assess the extent of the fractures and dislocations. If necessary, a CT scan may be performed to provide a more detailed view of the bone structures and any associated injuries.

In the emergency department, orthopedic surgeons will evaluate your injuries and determine the best course of action. This may involve surgical intervention to realign the bones and stabilize the knee joint. Open fractures typically require surgical cleaning and fixation to prevent infection and promote healing. The surgical approach may include the use of plates, screws, or rods to stabilize the fractured bones.

Post-surgery, rehabilitation will be crucial for recovery. Physical therapy will help restore range of motion, strength, and function to your knee. Initially, therapy may focus on gentle movements to prevent stiffness, gradually progressing to more intensive exercises as healing occurs. It’s important to follow your healthcare provider’s recommendations closely to avoid complications and ensure optimal recovery.

In summary, your knee injury is serious and requires immediate medical attention. The combination of fractures, dislocations, and potential ligament damage necessitates a comprehensive treatment plan involving both surgical and rehabilitative care. It’s essential to address these injuries promptly to minimize long-term complications and maximize your chances of returning to normal function. Please seek emergency care as soon as possible to begin the healing process.

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