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Lecture Notes- Orthopaedics and Fractures > Knee and Lower Leg > Flashcards

Knee and Lower Leg Flashcards

1
Q

What are the menisci

A

shock absorbers of the knee - they share the load transmitted across the joint

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2
Q

What does the anterior cruciate ligament control

A

forward movement of the tibia on the femur

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3
Q

What does the posterior cruciate ligament control

A

Backward movement

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4
Q

What is a locked knee

A

one which will not extend fully

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5
Q

What is genu varum

A

Bow leg

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6
Q

What is genu valgum

A

knock knee

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7
Q

What us generalised swelling of the knee due to

A

an effusion or to synovial thickening

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8
Q

During the medial gutter sweep, where is the fluid being swept into

A

hollows into the supra-patellar pouch and back again

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9
Q

What does Lachmann’s test

A

the ACL

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10
Q

What investigation is used to determine which ligaments are torn is a dislocated knee

A

MRI

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11
Q

What type of patients are more likely to have a patella dislocation

A

children and young adults

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12
Q

How do patella dislocations arise

A

Fall or blow to the side of the knee

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13
Q

What other injury does a patellar dislocation involve

A

a tear of the medial capsule and quadriceps expansion

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14
Q

What is the treatment for a dislocated patella

A

Reduction usually by straightening the knee

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15
Q

What collateral ligament strain is more common

A

Medial is more common than lateral

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16
Q

What is the diagnosis for a sports person who has a twisting injury and who heard a snap or pop and unable to continue playing

A

ACL tear until proven otherwise

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17
Q

When do PCL injuries arise

A

Dashboard injuries

goalkeepers

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18
Q

How is a PCL injury diagnosed

A

Posterior sag and posterior draw sign

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19
Q

In what situation does a patient require urgent surgery

A

Locked knee with acute ACL rupture

20
Q

What results in a comminuted fracture of the patella

A

Direct blow often against the dashboard of a car

21
Q

What is the treatment for a fractured patella

A

Surgery to reduce and fix but this can be difficult

22
Q

In what condition is a patient unable to perform a straight leg raise

A

Rupture of the quadriceps tendon

23
Q

What is the treatment for a ruptured quadriceps tendon

A

Surgical repair followed by a period of immobilisation and rehabilitation with physiotherapy

24
Q

How is a ruptured patella ligament different to a ruptured quadriceps tendon

A

Younger patients and more athletic with a history of patella tendinosis are more likely to have a rupture of patella ligament

25
Q

How are displaced fractures of the tibia and fibula bettie treated where there is significant disruption of the joint surface

A

Open elevation of the joint surface with a bone graft

26
Q

What are the treatment options for a tibial shaft fracture or fibula fracture

A

Internal fixation - most popular
External frame fixation
Conservative treatment
A close-fitting cast-brace

27
Q

What are some complications of lower limb fractures

A

non-union of tibial fractures
some degree of ischaemia of the deep muscles of the calf (Compartment syndrome)
Stiffness of knee, ankle and foot may delay full rehabilitation

28
Q

Can menisci tears heal

A

Yes

29
Q

What are the commonest knee injuries

A

tears of the menisci

30
Q

What are the typical features of a menisci tear

A

young male
twists the knee while it is flexed and the weight on that leg
Knee may lock

31
Q

What are the signs of a menisci tear

A

swelling, tenderness over the meniscus, muscle spasm and perhaps loss of full extension

32
Q

What meniscus is more likely to have a cyst

A

lateral meniscus

33
Q

What is a popliteal cyst

A

a painless swelling in the popliteal fossa often fluctuating in size

34
Q

Where do popliteal cysts arise from

A

one of the anatomical bursa

35
Q

When should a popliteal cyst be removed

A

When giving symptoms

36
Q

What are known as Baker’s cysts

A

Rheumatoid cysts infiltrating the calf muscles

37
Q

What are some predisposing factors to OA of the knee

A 
fractures 
infective conditions 
meniscus and ligamentous injuries
osteochondritis dissecans 
RA
38
Q

What is the treatment for OA in the knee

A

Conservative methods - lose weight, use stick, modify work and take analgesics and NSAIDs

39
Q

What are the 2 surgical options for OA in the knee

A

Osteotomy

Arthroplasty

40
Q

Who undergoes an osteotomy

A

younger patients - correct the abnormal alignment to allow the normal side of the knee to take more load

41
Q

Where are the most common sites for acute osteomyelitis in children in the lower limb

A

upper end o the tibia and the lower end of the femur

42
Q

What aids the treatment in all infective conditions around the knee

A

immobilisation of the joint

43
Q

What are the features of chronic infections

A

chronic pain and swelling, usually with severe muscle wasting

44
Q

What are some red flag signs of neoplastic conditions

A

Atypical pain
night pain
no history of injury
mass or swelling in a young patient

45
Q

How do loose bodies tend to cause symptoms

A

By becoming trapped between the joint surfaces

46
Q

What might loose bodies result from

A

Osteochondritis dissecans
osteochondral fractures
detached osteophytes usually in osteoarthritis
soft tissue fragments from a damaged meniscus
synovial chondromatosis

47
Q

What is the treatment for a loose body

A

removed using the arthroscope or by open operation only if it causes symptoms

Lecture Notes- Orthopaedics and Fractures (23 decks)

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