Management of Complex Knee Ligament Injuries

Initial evaluation of a knee with multiple ligament injuries begins with a thorough and complete neurovascular examina- tion, an assessment of the soft tissue, and determination of the instability pattern. Failure to recognize a vascular injury can lead to catastrophic limb dysfunction and ultimately to amputa- tion. Injury to the tibial and/or peroneal nerves can also have devastating conse- quences and is encountered in almost 25% of dislocated knees1. The modified Schenck classification2, in which not only ligamentous structures but also neurovascular injury and the presence of periarticular fracture are taken into account, is widely used to describe these injuries.

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