What is the initial management for lateral dislocation of the patella?

What is the initial management for lateral dislocation of the patella?

• A. Immediate immobilization in a cast
• B. Medically directed pressure on the patella while extending the leg
• C. Surgical reduction in the ED
• D. Ice and rest only

Answer: (B)

The key idea is to realign the kneecap with a closed reduction maneuver. When the patella has shifted laterally, the first step is to reposition it by extending the knee while applying gentle medial pressure on the patella to guide it back into the trochlear groove. This realignment is usually performed in the emergency department and often under analgesia or light sedation to minimize pain and muscle guarding. After successful reduction, reassess the neurovascular status of the leg and obtain knee radiographs to confirm proper alignment and to evaluate for associated injuries such as fractures. The knee is typically immobilized in a brace or knee immobilizer for a short period, followed by gradual rehabilitation focused on restoring range of motion and strengthening the quadriceps to reduce the risk of recurrence. Ice and rest alone don’t relieve the dislocation, and routine casting or immediate surgical reduction isn’t indicated for a simple, first-time lateral patellar dislocation.

The key idea is to realign the kneecap with a closed reduction maneuver. When the patella has shifted laterally, the first step is to reposition it by extending the knee while applying gentle medial pressure on the patella to guide it back into the trochlear groove. This realignment is usually performed in the emergency department and often under analgesia or light sedation to minimize pain and muscle guarding.

After successful reduction, reassess the neurovascular status of the leg and obtain knee radiographs to confirm proper alignment and to evaluate for associated injuries such as fractures. The knee is typically immobilized in a brace or knee immobilizer for a short period, followed by gradual rehabilitation focused on restoring range of motion and strengthening the quadriceps to reduce the risk of recurrence.

Ice and rest alone don’t relieve the dislocation, and routine casting or immediate surgical reduction isn’t indicated for a simple, first-time lateral patellar dislocation.