Complex multiligament knee reconstruction following high-impact trauma with primary repair and internal bracing: a case report

Abstract

Open fracture-dislocations of the knee are high-impact injuries often associated with extensive ligamentous damage, presenting significant challenges in orthopaedic trauma care. The rarity of such injuries makes the pre-operative planning and post-operative rehabilitation especially challenging. Standardized treatment consists of either early - <3weeks, or late - >3weeks reconstruction with autografts. This case report discusses the surgical management of a complex knee trauma with early repair of all ligaments using modern fixation methods. Our case presents a 33-year-old male sustained a complex open fracture-dislocation of the left knee. The injury included a posterolateral tibial plateau fracture, comminuted patellar fracture, avulsion of the lateral femoral condyle, and complete ruptures of the ACL, PCL, MCL, and LCL. Initial emergency surgery involved wound debridement and external fixation. Subsequent surgeries addressed ligament repair, using modern fixation techniques, like Internal Brace. The patient achieved excellent recovery, returning to daily activities within 18 weeks without complications. This case underscores the potential benefits of primary ligament repair over traditional reconstruction in managing complex knee injuries. The successful outcome highlights the importance of early intervention, and modern fixation techniques in optimizing recovery.