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TL;DR
A 66-year-old man was found on the floor approximately 5 days after an unwitnessed fall, presenting with bilateral knee pressure ulcers (grade 3 right, grade 4 left) — a site not previously reported in the literature.
Annals of Medicine and Surgery · 4 authors, 3 centres
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A 66-year-old man was found on the floor approximately 5 days after an unwitnessed fall, presenting with bilateral knee pressure ulcers (grade 3 right, grade 4 left) — a site not previously reported in the literature.
This case report describes a 66-year-old male found on the floor approximately 5 days after an unwitnessed fall, presenting with bilateral knee pressure ulcers graded as 3 (right knee) and 4 (left knee). On admission, vitals were unstable with SpO2 94%, BP 100/70 mmHg, and heart rate 110 bpm, though Glasgow Coma Scale was 15/15 and CT head and ECG were unremarkable. Blood investigation revealed acute kidney injury due to rhabdomyolysis secondary to prolonged immobility and sepsis. The patient was admitted to the intensive therapy unit for over one month, treated with IV antibiotics and dialysis, then stepped down to the renal ward. Pressure ulcers were managed conservatively with pressure removal, wound cleaning, and regular dressing. The patient was discharged on 17 March 2023 to a care home with wounds healing well. A literature review by the authors found no prior reports of pressure sores at the knee. As a single case report, the findings are descriptive and not generalizable, but they highlight the need to examine all bony prominences in patients following unwitnessed falls.