After spontaneous reduction of a high-energy knee dislocation, pedal pulses are symmetric but the ankle-brachial index is 0.86 and the foot has

Question

After spontaneous reduction of a high-energy knee dislocation, pedal pulses are symmetric but the ankle-brachial index is 0.86 and the foot has intermittent paresthesia. What should happen next?

Accepted Answer

Obtain urgent CT angiography and involve vascular and orthopedic surgery despite palpable pulses

Answer

Use a normal capillary refill time to overrule the abnormal ankle-brachial index

Answer

Order outpatient MR angiography because acute CT contrast may provoke arterial thrombosis

Answer

Apply a hinged brace and arrange sports-medicine review before any vascular assessment

Answer

Observe serial pulses for six hours and discharge if they remain palpable without repeat testing

Knee dislocation with vascular injury — RCPSC EM MCQ

After spontaneous reduction of a high-energy knee dislocation, pedal pulses are symmetric but the ankle-brachial index is 0.86 and the foot has intermittent paresthesia. What should happen next?