Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right knee pain following a direct trauma/fall. Reports inability to bear weight, significant swelling, and localized tenderness over the patella. No neurovascular deficits noted in the distal extremity. Mechanism of injury consistent with direct impact to the anterior knee.
Clinical Examination Findings
Right knee inspection reveals significant anterior swelling, ecchymosis, and a palpable gap or step-off at the patellar mid-substance. Tenderness to palpation is maximal over the patella. Active straight leg raise is absent/impaired. Range of motion is severely limited by pain. Distal pulses (DP/PT) are 2+ and symmetric; capillary refill < 2 seconds. Sensation intact to light touch in all dermatomes.
Treatment Protocol
Immobilization of the right knee in full extension using a knee immobilizer. Ice application for 20 minutes every 2 hours. Elevation of the right lower extremity above heart level. Analgesia provided. Orthopedic consultation requested for surgical fixation evaluation. Non-weight bearing status strictly enforced.