Hinged-Knee External Fixator Used to Reduce and Maintain Subacute Tibiofemoral Coronal Subluxation

Abstract

Dislocation of the knee is a rare phenomenon that is becoming increasingly recognized with the expansion of its definition to include knees presenting with multiligament compromise. Hinged external fixators are now considered a viable supplementary treatment option in the management of acute ligament repair or reconstruction but their use in the management of subacute or chronic tibiofemoral dislocations or subluxations is less well defined. We report a case of a hinged-knee external fixator used to facilitate and maintain reduction of a chronic coronal tibial subluxation that presented after repair of an acute knee dislocation with lateral ligament injury secondary to a motor vehicle accident. At 5-year follow-up, the patient treated with hinged external fixation had a stable joint, was able to tolerate regular aerobic exercise, was minimally symptomatic, and did not require more extensive ligament reconstruction. Although there are reports on postoperative use of hinged external fixation to maintain the reduction of chronic or subacute knee dislocations in the sagittal plane after cruciate ligament repair, there are no reports on management of subacute tibiofemoral subluxation in the coronal plane.