Outcome Analysis of Neglected Musculoskeletal Injuries of Knee

Abstract:
Background: Old unreduced dislocations of knee are relatively uncommon in adults but in our hospital we have
seen many cases presenting with neglected knee dislocation and neglected distal femur fractures, fracture of
patella and fracture of proximal tibia with a minimum period of neglect of 1 week. Due to the increased need for
restoration of the normal knee in Indians we have attempted to devise a strategy for treatment of these neglected
injuries to produce the best outcome possible for the patient.
Materials and Methods: 17 patients with neglected injuries around knee joint were selected based on a set
criteria and was put on a treatment protocol according to various factors like age, outcome expected,
occupation of the patient etc and they evaluated at three stages pre intervention, intervention and post
intervention stage. Then after a serial follow up period of minimum 1 year the final outcome was recorded.
Results: In our study neglected trochanteric fractures had a better outcome when compared to neglected neck of
femur that underwent fixation of fractures. In neck of femur fracture that underwent prosthetic replacements
had better outcome than fracture fixations of neglected neck of femur fractures Conclusion: In conclusion we have proven that irrespective of duration of neglect surgical procedures for neglected injuries are always better than watchful neglect. The complications and outcome in all the cases
depended on many factors as even in some cases with longer neglect duration excellent outcome was possible
but in some cases with shorter neglect duration also fair outcome was only possible.