A Twist of Fate

A dislocated patella (kneecap) can result from direct injury to the inner side of the knee, such as an impact with a rock face or the ground, or a twisting motion when climbing. It can also result from the stress of running downhill. Women, whose wider pelvises redirect the pull of their patella tendons towards the outside of their knees, are more susceptible to patella dislocations than men.

The pain of a dislocated patella is somewhat less than a dislocated shoulder, but still considerable. The victim won't be able to walk and will likely be sitting on the ground with her knee bent. The normally rounded front of her knee will be flat and there will be an abnormal bulge—her patella—on the outside of her knee.

In order to splint and immobilize this injury, you must gently straighten the victim's leg. During this process, the patella will sometimes move back to its normal position spontaneously. If this happens, splint the leg so it does not bend. You can improvise a reasonable splint by wrapping Ensolite (closed cell foam) or an inflated Thermarest pad around the knee and taping it above and below the joint. The victim may then be able to assist in her evacuation by putting some very minimal weight on the injured leg and leaning on friends for support.

If the patella does not reduce (return to its normal position) during straightening, the victim cannot bear any weight on her injured leg and must be carried out on your back or in a makeshift litter. First, place padding between the victim's knees and legs. Then, with gauze bandages or similar improvised materials, buddy splint her injured leg to the other one. Wind the bandages around the victim's legs and feet, but avoid strapping directly on her kneecap, so she can bend and hold her leg in the most comfortable position during the evacuation.

Even if the patella moves back into place, the victim should seek medical attention on her return to civilization.