Triple blow injury to a limb: Ipsilateral hip and knee dislocation with vascular occlusion

Ipsilateral hip and knee dislocation (double blow) occurring simultaneously during trauma are rare occurrences that are associated with secondary complications. These are high energy injuries that warrant acute emergency management more so if associated with vascular compromise. We encountered a pol...

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Bibliographic Details
Published in:Journal of emergencies, trauma and shock trauma and shock, 2020-10, Vol.13 (4), p.309-311
Main Authors: Jain, Mantu, Sathia, Siddhartha, Mahapatra, Rudra, Swaroop, Shakti, Doki, Sunil
Format: Article
Language:English
Subjects:
Amputation
Case Report
Case reports
delayed
Developing countries
Emergency medical care
Emergency preparedness
Gangrene
hip dislocation
Hip joint
Joint and ligament injuries
Knee
knee dislocation
Knee injuries
LDCs
Trauma
Vascular occlusion
Veins & arteries
vessel occlusion
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Summary:Ipsilateral hip and knee dislocation (double blow) occurring simultaneously during trauma are rare occurrences that are associated with secondary complications. These are high energy injuries that warrant acute emergency management more so if associated with vascular compromise. We encountered a poly trauma patient having a combined right anterior hip and ipsilateral knee dislocation with vascular occlusion at popliteus level apart from associated segmental radius fracture of the left upper limb. This young patient presented after 22 h being referred form elsewhere making the situation critical to the surgical team. An attempted thrombolysis was done but as gangrenous changes started, we ended up in a below knee amputation. This case highlights a typical scenario in a developing country where facilities involving super specialty services are scarce and even patients are complacent about need for emergent referral. All this adds to surgical dilemma as guidelines are unclear for the best treatment.
ISSN:0974-2700
0974-519X
DOI:10.4103/JETS.JETS_25_20