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MSK II > Knee Pathology and Fractures > Flashcards

Knee Pathology and Fractures Flashcards

1
Q

What is the most common type of knee fracture?

A

Patella (40%)

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2
Q

What type of fracture makes up 32% of all knee fractures?

A

Tibial Plateau

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3
Q

Distal femur and tibial spine fractures make up what percentage of all knee fractures?

A

5-10%

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4
Q

What type of knee fracture(s) is least common? (<5%)

A
  • Tibial tuberosity
  • Segond fracture
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5
Q

What percentage of ALL knee injuries is related to fracture?

A

6%

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6
Q

Is the Ottawa knee rule best for ruling up or down need for imaging?

A

Rule out
Sensitivity: 90-100%
specificity: 50%

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7
Q

What factors must have at least one present to allow for imaging per the Ottawa Knee Rule?

A
  • 55 years old
  • Isolated tenderness of patella
  • Tenderness of fibular head
  • > 90° of knee flexion
  • Unable to weight bear, or in ER for 4 steps (limping is acceptable)
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8
Q

What factors must have at least one present to allow for imaging per the Pittsburgh Knee Rule?

A
  • > 50 years old OR <12 years old
  • Unable to weight bear, or in ER for 4 steps (limping is acceptable)
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9
Q

Benefit of using ultrasound for imaging of the knee?

A
  • Non-invasive option for assessment of soft tissue injuries
  • Identifying Cysts (Baker’s)
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10
Q

What imaging option is utilized first for potential knee pathology?

A

X-Ray

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11
Q

Goals of rehabilitation during
immobilization?

A

Minimal visits
* Maximize safe function
* Prevent complications of injured tissues
(bone and soft tissues)
* Always communicate with
physician/surgeon!
* Stability of fracture?
* Other compromised tissues?
* Maintain health of uninvolved tissues
* Cardiovascular system
* Respiratory system
* Minimize risk of pressure sores

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12
Q

Potential MOI of patellar fractures?

A
  • Anterior knee impact trauma
  • Hyperflexion/contraction of quadriceps
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13
Q

What type of imaging is best for visualizing patella fractures?

A

X-Ray, Sunrise View

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14
Q

Most common type of patella fracture? (direction)

A

Transverse (50-80%)

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15
Q

What patella abnormality is noted when a portion of the patella does not completely heal along the bony edges of the patella?

A

Bipartate patella

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16
Q

Treatment for non-displaced patellar fractures?

A
  • Immobilization up to 6 weeks
  • Decreased WB
17
Q

(T/F) Displaced patella fractures commonly require surgery?

A

TRUE

18
Q

Potential MOI for a patellar dislocation?

A

Impact or sudden twisting of the knee, valgus load

19
Q

What direction do most (90%) of patellar dislocations occur?

A

Lateral

20
Q

(T/F) Patellar dislocations are most common in males

A

FALSE

21
Q

What type of fracture may occur with a patellar dislocation?

A

Osteochondral fracture

22
Q

Potential MOI for a distal femur fracture?

A

Axial loading (fall or MVA)

23
Q

Treatment options for a distal femur fracture?

A
  • Traction or casting/bracing
  • NWB up to 3 months
24
Q

Potential MOI for a Epiphyseal Complex Fracture (Salter-Harris Classification)

A

Direct trauma with rotation, hyperextension, or valgus stress

25
Q

What type of Epiphyseal Complex Fracture (Salter-Harris Classification) is most common

A

Type II (Above)

26
Q

What type of Epiphyseal Complex Fracture (Salter-Harris Classification) is least common?

A

Type V (Erasure)

27
Q

What type of Epiphyseal Complex Fracture (Salter-Harris Classification) typically does NOT require surgery?

A

Type I,II
Immobilized for 4-6 weeks

28
Q

What type of Epiphyseal Complex Fracture (Salter-Harris Classification) typically DOES require surgery?

A

Type III, IV, V

29
Q

What type of fracture mimics ACL MOI in adolescents?

A

Tibial Spine (Tibial Eminence) Fracture

30
Q

MOI of a Tibial Spine (Tibial Eminence) Fracture?

A
  • Rapid deceleration or hyperextension/rotation
  • Fall from a bike is a very common mechanism
31
Q

How long is recovery from a Tibial Spine fracture?

A

Full return to activities usually within 6 months

32
Q

Potential MOI of a Tibial Tubercle fracture?

A

Strong contraction of quads while jumping, or
during forced knee flexion

33
Q

Tibial Tubercle Fractures are most common in what population?

A
  • Most common in adolescents (12-15 yrs old)
  • males > females
  • < 1% of pediatric fractures
34
Q

Potential MOI of a Tibial Plateau Fracture?

A
  • Axial load
  • Fall or MVA
35
Q

How long is a patient typically non-weight bearing following a tibial plateau fracture?

A

Non-weight bearing up to 3 months

36
Q

What type of a fracture is most typically accompanied with an ACL injury?

A

Segond Fracture

37
Q

Potential MOI for a Segond Fracture?

A
  • Most commonly occurs via forceful internal rotation and
    varus stress
  • Different from most common MOI for ACL injuries
38
Q

Potential MOI for a tibiofemoral dislocation?

A

Severe traumatic injury (MVA - dashboard, fall from height,
crush, athletic injury

39
Q
A

MSK II (6 decks)

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