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NYCC Bone & Joint > Knee Injuries > Flashcards

Knee Injuries Flashcards

1
Q

What timeframe do the Ottawa Knee Rules apply?

A

knee inj <7 days old

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2
Q

If there are no positive criteria on Ottawa Knee Rules, what is the chance of a significant fracture?

A

<1%

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3
Q

What are the Ottawa knee rules?

A

“OR” rules (any of the following):
- age >55yrs
- fib head tenderness
- isolated tenderness of patella
- inability to flex 90 deg (AROM)
- inability to bear weight for 4 steps post-inj AND in clinic (regardless of limping)

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4
Q

What is a bumper/fender fracture?

A

depressed tibial plateau fx (80% lateral plateau)

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5
Q

What is the mechanism of a bumper/fender fracture?

A

valgus force (fem condyle driven into tibial plateau)

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6
Q

What radiographic finding will be present for a bumper/fender fracture?

A

FBI sign (liphemarthrosis)

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7
Q

What population commonly experiences bumper/fender fractures?

A

over 50yrs (osteoporosis)

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8
Q

What is a segond fracture?

A

avulsion of anterolateral lig, usually w/ avulsion of ITB insertion (Girdy’s tubercle), on lateral aspect of lateral tibial plateau

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9
Q

What is the mechanism of a Segond fracture?

A

pivot-shift

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10
Q

What soft tissues may be associated with a Segond fracture?

A
  • ACL tear (90%)
  • meniscal tear (70%)
  • ITB
    (LCL typically intact)
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11
Q

What is your next step if you suspect a Segond fracture?

A

MRI for soft tissue injuries

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12
Q

What is the mechanism of a patellar fracture?

A

direct or indirect trauma

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13
Q

What are the 4 types of patellar fractures?

A
  • transverse
  • stellate
  • vertical
  • osteochondral
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14
Q

What is the most common type of patellar fracture?

A

transverse

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15
Q

What is the clinical presentation of a patellar fracture?

A
  • patellar tenderness
  • quadriceps weakness
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16
Q

What type of patellar fracture occurs secondary to a dislocation?

A

osteochondral fx

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17
Q

What 2 types of patellar fractures require a sunrise view to visualize on a radiograph?

A

vertical
osteochondral

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18
Q

What is the most common direction of patellar dislocation?

A

lateral

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19
Q

What is the mechanism of a patellar fracture?

A

pivot-shift

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20
Q

What should you look for if you are suspect patellar dislocation?

A

osteochondral fx

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21
Q

What kissing contusions may be present due to lateral patellar dislocation?

A
  • medial facet of patella
  • lateral femoral condyle
    (requires sunrise view)
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22
Q

What is the clinical significance of a femorotibial dislocation

A
  • severe, life-threatening
  • injuries of popliteal a & common peroneal n are common
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23
Q

What directions may a femorotibial dislocation occur in?

A

anterior or posterior

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24
Q

What soft tissue structures may be affected by a femorotibial dislocation?

A

all intra & extra capsular ligamentous structures usually ruptured

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25
Q

What is the mechanism of femorotibial dislocation?

A

MVA or fall from very high

26
Q

What sex do ACL injuries occur more in?

A

females (2-8:1)

27
Q

What is the mechanism of an ACL injury?

A

pivot-shift

28
Q

What imaging modality is best for ACL injuries?

29
Q

When are orthopedic tests most sensitive for an ACL injury?

A

within 6 mins of inj

30
Q

What kissing contusions may be associated with ACL injuries?

A
  • lateral femoral condyle
  • posterior tibial plateau
31
Q

What injuries may be associated with ACL injuries?

A
  • O’Donoghue’s unhappy triad
  • osteochondral femoral fx
  • tibial spine avulsion
  • segond fx
  • PCL inj
32
Q

What is O’Donoghue’s unhappy triad?

A
  • ACL tear
  • post. horn (or any) medial meniscal tear
  • MCL tear
33
Q

What is the mechanism of a PCL injury?

A

direct blow to tibia (land on tibial tuberosity)

34
Q

What is the most common location for osteochondritis dissecans (OCD)?

35
Q

What is your next step if you suspect an osteochondral fracture?

A

MRI arthrogram

36
Q

Where are osteochondral fractures of the knee usually found?

A

lateral aspect of medial femoral condyle (non-weight bearing surface)

37
Q

What is a chondral injury?

A

injury limited to cartilaginous layer
(bone bruise, deep jt pain, no xray findings)

38
Q

What injuries are proximal fibular fractures associated with?

A
  • knee ligament injuries
  • lateral tibial plateau fx
  • ankle inj (Maisonneuvre fx)
39
Q

What is the clinical significance of a proximal fibular fracture?

A

concern for common peroneal n inj

40
Q

What is a trampoline fracture?

A

fx of proximal tibia metaphysis (kids 2-10)

41
Q

What is the diagnosis?

A

Bumper/fender fx

42
Q

What is the diagnosis?

A

Osteochondritis dissecans

43
Q

What is the diagnosis?

A

Bumper/fender fx

44
Q

What is the diagnosis?

A

Lateral patellar dislocation

45
Q

What is the diagnosis?

A

Tibial spine avulsion fx

46
Q

What is the diagnosis?

A

Osteochondral fx

47
Q

What is the diagnosis?

48
Q

What is the diagnosis?

A

Stellate patellar fx

49
Q

What is the diagnosis?

A

Trampoline fx

50
Q

What is the diagnosis?

A

Vertical patellar Fx

51
Q

What is the diagnosis?

A

Trampoline fx

52
Q

What is the diagnosis?

A

Vertical patellar fx

53
Q

What is the diagnosis?

A

Tibial tuberosity fx

54
Q

What is the diagnosis?

A

Transverse patellar fx

55
Q

What is the diagnosis?

56
Q

What radiographic sign is present?

A

FBI sign (lipohemarthrosis)

57
Q

What is the diagnosis?

A

Proximal fibular fracture

58
Q

What is the mechanism of this diagnosis?

A

Pivot-shift
(Dx: Segond Fx)

59
Q

What is the diagnosis?

A

Posterior femorotibial dislocation

60
Q

What is the diagnosis?

A

Anterior femorotibial dislocation

NYCC Bone & Joint (52 decks)

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