Reduction of acute patellar dislocation under femoral nerve blockade

Complications of traumatic reduction of the acutely dislocated patella may be significant, including osteochondral and chondral defects of either patella or lateral femoral condyle. The true incidence of chondral damage due to traumatic reduction both before presentation and in emergency departments is unknown. Femoral nerve block can produce good analgesia and excellent muscle relaxation with an effective block, allowing early atraumatic reduction if spontaneous reduction has not already occurred. This method was employed in three cases, using prilocaine 1.5% solution with adrenaline 1:200,000 via the single injection technique, with good results. Femoral nerve block is a feasible and well tolerated procedure in our experience, and may help reduce complication rates in patellar dislocations. 1993 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine