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Patellar Injuries, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Dislocation

  • Usually caused by sudden flexion and external rotation of tibia on femur, with simultaneous contraction of quadriceps muscle

  • Direct trauma to patella is a less common cause

  • ...

Diagnosis

Signs and Symptoms

Dislocation

  • History of feeling knee “go out”; popping, ripping, or tearing sensation

  • Pain

  • Inability to bear weight

  • Obvious lateral deformity of patella

  • Mild to moderate swelling

  • ...

Treatment

Pre-Hospital

Patient should be transported in supine position with knee flexed and supported. 

Initial Stabilization/Therapy

Appropriate history and physical exam to identify any associated inj...

Follow-Up

Disposition

Admission Criteria

  • Patients with superior, medial, or intra-articular dislocation or in whom a lateral dislocation cannot be reduced require orthopedic consultation in the ED and p...

Pearls and Pitfalls

  • Lateral patella dislocations often reduce spontaneously prior to arrival in ED; do not dismiss patient's history of dislocation.

  • In patella tendon ruptures, tendon defect may not be...

Additional Reading

  • Ahmad  CS, McCarthy  M, Gomez  JA, et al. The moving patellar apprehension test for lateral patellar instability. Am J Sports Med.  2009;37(4):791–796.

  • Fithian  DC, Paxton  EW, ...

Codes

ICD9

  • 726.64 Patellar tendinitis

  • 836.3 Dislocation of patella, closed

  • 836.59 Other dislocation of knee, closed

  • 822.1 Open fracture of patella

ICD10

  • M76.50 Patellar tendinitis, unspecified knee

  • S83.006A ...

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