Injuries of the Lower Limb Flashcards
What are the three types of knee joint injuries?
Meniscal, ligament and articular cartilage injuries
What are the 6 mechanisms of injury for traumatic knee injuries?
Hyperflexion, hyperextension, varus (outwards), valgus (inwards), rotation and combination
What is the history of meniscal injuries?
Twisting injury in weight bearing, acute pain, catching, clicking, locking, giving way
What is the mechanism of injury for meniscal injuries?
Detachment of the meniscus, longitudinal/transverse rupture
What are the clinical findings of meniscal injuries?
Swelling, limited ROM, joint line tenderness, pain with squatting, positive McMurray’s test
What investigations are used for meniscal injuries?
MRI and ultrasound
What is the treatment for meniscal injuries?
Arthroscopy - tear is removed or repaired
What condition is a risk associated with meniscal injuries?
Osteoarthritis
What are four knee ligaments that can be injured?
Anterior cruciate, posterior cruciate, medial collateral, lateral collateral
What is the mechanism of injury for ACL injuries?
Twisting, hyperextension, weight bearing
What is the history of ACL injuries?
Injury mechanism, hear/feel snap/crack, pain, loss of function, swelling
What are the clinical findings of ACL injuries?
Specific tests - Lachman’s, pivot-shift
What investigations are used for ACL injuries?
X-ray, MRI, CT scan
What are the treatments and outcomes of ACL injuries?
Surgery vs. conservative; risk of osteoarthritis and recurrence
What is the mechanism of injury for PCL injuries?
Direct blow to anterior tibia, hyperextension
What is the history of PCL injuries?
Injury mechanism, pain, swelling, often presents late
What is considered in the examination of PCL injuries?
Swelling, posterior sag of tibia, posterior drawer test
What investigations are used for PCL injuries?
X-ray, MRI
What are the treatments for PCL injuries?
Usually conservative, surgery if unstable
What are the outcomes of PCL injuries?
Usually able to return to normal activity, always be aware of posterolateral corner injury
What is the mechanism of injury for valgus injuries?
Impact against the outside of the knee, pushing it inwards (lateral force)
What is the mechanism of injury for varus injuries?
Impact against the inside of the knee, pushing it outwards (medial force)
What is the mechanism of injury for medial collateral ligament (MCL) injuries?
Valgus stress
What is considered in the examination of MCL injuries?
Pain/tenderness medially, +/- swelling, gapping with valgus stress, grade 1/2/3
What investigations are used for MCL injuries?
X-ray, MRI
What are the treatments for MCL injuries?
Grade 1: Conservative, ROM brace
Grade 2: Often conservative, sometimes surgery
What is the mechanism of injury for lateral collateral ligament (LCL) injuries?
Varus stress
What is considered in the examination of LCL injuries?
Pain laterally, gapping laterally with varus stress, grade 1/2/3
What investigation is used for LCL injuries?
MRI
What are the treatments for LCL injuries?
Grade 1/2: Conservative
Grade 3: Surgery
The mechanism and clinical findings of articular cartilage injuries are similar to what other type of knee injury?
Meniscal
What is the treatment for articular cartilage injuries?
Arthroscopic debridement
What is a type of articular cartilage injury?
Osteochondritis dissecans
What is osteochondritis dissecans?
Death of articular cartilage and bone fragment, release of bone & articular cartilage into the joint
When does osteochondritis dissecans usually occur?
Adolescence
What are the symptoms of osteochondritis dissecans?
Pain, swelling, catching, locking
What is the anatomy of anterior knee pain?
Quadriceps mechanism, Q angle, patella mechanics
What are the causes of anterior knee pain?
Retropatella pain syndrome, patella tendinosis, traction apophysistis
What is the mechanism of injury for retropatella pain syndrome?
VMO, lateral structures, feet, exercise