Question

Case Scenario: A mother drops off her 15-year-old son at soccer practice. He plays for a traveling team, and she is headed to the grocery store to do some shopping while he is occupied. While at the store, she receives a telephone call from the coach, telling her that her son was kicked just below the knee, causing him to fall to the ground. He was wearing his shin guards but complains that it hurts too much to walk. The mother turns around and heads back to the soccer field. When she arrives, her son is sitting on the bench with ice on his leg. The coach and a teammate help her get him into the car, and she drives him to the emergency department. An x-ray image shows a fracture near the knee with subluxation.

1. Question: The doctor tells the mother that her son has suffered a complete separation of a ligament from its bony attachment, and they will attempt a closed reduction. Describe this procedure to the mother. You will need to defend your answer using specific facts, data, and other information.

Answer 1

If the foot is forcefully rotated externally,there is fracture of bone with distruption of the ligaments so that the ankle has bone fracture with subluxation of the joint (in this case knee) .Subluxation result in complete or partial separation of joint or dislocation of a joint.

For this condition 'closed reduction' is done ,it is a procedure to set (reduce) a broken bone without cutting the skin open ( that is without a surgery ). The broken bone is put back in place , which allows it to grow back together. It works best when it is done as soon as possible after the bone breaks.As the procedure is painful , the patient is often given Local Anaesthetic or nerve block to numb the area which is mostly given as a shot. The medical practitioner will push or pull the ends of the fracture bone until they line up. This part of the procedure is called as Reduction. Then doctor will put a cast or splint on the affected leg to help hold the bone in place while it heals.The Doctor checks if the bone is lined up properly by taking an X-ray .The above-knee cast is applied for 3 weeks followed by a below knee walking cast for 3 weeks.It will take 4-6 weeks for the tissues to heal .During this time ,the knee must be protected from another injury.

Once a patella Dislocation or subluxation has occured it is more likely to happen again thus after the procedure , proper rest and ice therapy should be followed.