7 Ligamentous Sprains and Strains Flashcards
What are the 3 grades of tear?
Grade 1 - <50% tissue disruption, minimal LoF, pain, no laxity
Grade 2 - >50% tissue disruption, significant LoF, pain, some laxity
Grade 3 - complete disruption and LoF, pain, marked laxtiy and no end point of movement
Describe the 3 phases of repair
Time, pathology, management
- Acute inflammatory phase 0-72h
Mgmt is RICE - Repair phase 48h-6w
regeneratino of myofibres and deposition of collagen in a non-uniform manner
Mgmt is restore RoM and maintain fitness - Remodelling phase 2w-12m
maturation of new myofibers and reorientation of collagen in direction of stress
Mgmt is restore RoM and strengthen and stretch new tissue
What are the 3 principles of sprain and strain treatment?
- address the problem
- promote quality and speed of healing
- prevent further damage, complications and recurrence
LATERAL ANKLE SPRAIN
mechanism
injury
test
management
Mechanism - inversion and plantar flexion
Injury - anterior talo-fibular lig. (66%) + calcaneo-fiular lig. (20%)
Test - anterior drawer test
Management - RICE, weight bearing, immobilistion if grade 3, bracing, exercises for proprioception and strength
ANTERIOR CRUCIATE LIGAMENT INJURY
list the 4 theories of mechanism of action
- ligament dominance - knee valgus, hip add and int. rotation
- trunk dominance - poor trunk control leads to valgus knee force
- quadriceps dominance - excessive force increases pull on ACL in deceleration with slight knee flexion, aka netball
- leg dominance - assymetries between legs
ANTERIOR CRUCITATE LIAGMENT INJURY
Injury
Test
Management
Injury - tear of ACL, usually a pop or snap sound, possible haemarthrosis
Test - imaging, swipe effusion, anterior drawer (sensitivity varies), Lachman’s test is most sensitive
Management - depends on age and use:
SemiT/gracilis/patella tendon/hamstring graft reconstruction
Rehab with brace, strengthening, balance, return to sport
