Knee, Patella & Tibial Injuries
Recognise instability, extensor disruption and neurovascular risks around the knee and leg.
Quick revision ↓ Medical Dictionary
01Initial assessment
Assess mechanism, swelling, deformity, skin and ability to extend the knee. A large acute effusion can accompany fracture or major ligament injury. Severe pain and swelling may limit examination; document limitations and plan reassessment rather than forcing provocative tests in the acute setting.
02Knee dislocation
A dislocation may reduce before arrival, leaving a relatively normal-looking knee with major ligament and vascular injury. Assess distal perfusion and use the vascular evaluation pathway even after apparent reduction. Serial examination matters because an arterial injury can evolve despite an initially palpable pulse.
03Extensor mechanism
Inability to perform a straight-leg raise can suggest patellar fracture or quadriceps or patellar tendon disruption, though pain can confound the test. Assess the full clinical picture and imaging. Preserve the limb in an appropriate support and obtain specialist advice when extensor continuity is uncertain.
04Tibial fractures
Tibial shaft and plateau injuries require attention to soft tissues, compartment syndrome and joint involvement. Swelling can affect the timing and type of definitive fixation. Monitor neurovascular state and pain trends; a small wound may mark an open fracture despite modest external bleeding.
05Ligaments and recovery
Ligament or meniscal injury is assessed using history, examination and selected imaging after urgent threats are addressed. A truly locked knee needs timely review. Rehabilitation and return to sport depend on stability, healing and functional recovery, not pain reduction alone.
High-Yield Revision
- A reduced knee dislocation can still threaten arterial supply.
- Check the extensor mechanism.
- Tibial injury needs ongoing compartment surveillance.
Common Pitfalls
- Assuming normal appearance excludes prior knee dislocation.
- Forcing acute ligament tests through severe pain.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.