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Selected Instructional Course Lecture   |    
Management of Complex Knee Ligament Injuries
Gregory C. Fanelli, MD1; James P. Stannard, MD2; Michael J. Stuart, MD3; Peter B. MacDonald, MD4; Robert G. Marx, MD, MSc, FRCSC5; Daniel B. Whelan, MD6; Joel L. Boyd, MD7; Bruce A. Levy, MD3
1 Department of Orthopaedic Surgery, Geisinger Medical Center, 115 Woodbine Lane, Danville, PA 17822-5212
2 Department of Orthopaedic Surgery, University of Missouri, 1 Hospital Drive, Columbia, MO 65212
3 Department of Orthopedic Surgery (M.J.S. and B.A.L.) and Sports Medicine Center (M.J.S.), Mayo Clinic, 200 First Avenue S.W., Rochester, MN 55906
4 Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB R3M 3E4, Canada
5 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
6 University of Toronto, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada
7 TRIA Orthopaedic Center, 8100 Northland Drive, Minneapolis, MN 55431
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits of less than $10,000 or a commitment or agreement to provide such benefits from commercial entities (Biomet and Arthrex).

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2011 in Instructional Course Lectures, Volume 60. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Copyright © 2010 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Sep 15;92(12):2235-2246
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Extract

Initial evaluation of a knee with multiple ligament injuries begins with a thorough and complete neurovascular examination, an assessment of the soft tissue, and determination of the instability pattern. Failure to recognize a vascular injury can lead to catastrophic limb dysfunction and ultimately to amputation. Injury to the tibial and/or peroneal nerves can also have devastating consequences and is encountered in almost 25% of dislocated knees1. The modified Schenck classification2, in which not only ligamentous structures but also neurovascular injury and the presence of periarticular fracture are taken into account, is widely used to describe these injuries.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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