Occult knee dislocation: the importance of secondary survey

A large haematoma was noted over the posterior aspect of the right knee joint with rupture of the hamstring tendons, the posterior joint capsule, both collateral ligaments, and both cruciate ligaments. Kaufman et al in their series showed a low but definite (13%) frequency of nonocclusive arterial injury (spasm or intimal flap) after traumatic dislocation of the knee. 3 Progression to complete occlusion, although rare, has been reported. 4 Prompt recognition of the presence of an arterial injury and the restoration of blood flow are paramount for limb salvage.