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MSK 2 test 1 > Knee Pathology- fractures > Flashcards

Knee Pathology- fractures Flashcards

1
Q

knee fracture percentages

A

40% patella
32% tibial plateau

5-10% distal femur, tibial spine

<5% tibial tuberosity, segond fracture

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2
Q

fracture screenings

A

ottawa knee rule
sn- 90-100%
sp-50%

pittsburgh knee rule
sn->90%
sp- 60%

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3
Q

ottawa knee rule

A

age 55 or older
isolated tenderness of patella
tenderness over fibular head
unable to flex knee >90
unable to weight bear immediately or 4 steps in ER

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4
Q

pittsburg knee rule

A

blunt trauma or a fall and…

older than 50 or younger than 12
inability to take 4 steps in ER

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5
Q

imaging options

A

xray
ct
mri
us

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6
Q

xray

A

bony assessment
quick and inexpensive

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7
Q

ct scan

A

bones
more sensitive than xrays
quick, more expensive

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8
Q

MRI

A

assesses soft tissue injuries
also bony assessment
more time more expensive

dont do with metal in body

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9
Q

ultrasound

A

non invasive
soft tissues
good for identifying cysts

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10
Q

rehab during immobilization

A

minimal visits
maximize safe functions
prevent complications
maintain health of other tissues
minimize pressure sores
cardiopulmonary system

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11
Q

rehab for post immobilization

A

make sure bony stability is achieved

pain control
patient education
progressive manual therapy
HEP
return to desired activities

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12
Q

patellar fracture

A

MOI- trauma to anterior knee

impact
hyperflexion/ contraction of quadriceps

sunrise xray

transverse most common
bipartate patella

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13
Q

patellar fx treatments

A

nondisplaced- immobilize 6 wks; decreased wt bearing

displaced- surgery can be necessary; immobilize and limit wt bearing

initiate pain control activities, ROM, strengthening

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14
Q

patellar dislocations

A

MOI- impact or sudden twisting of knee, valgus

majority dislocate laterally
girls > boys

osteochondral fracture can occur

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15
Q

patellar dislocation rehab

A

patient education
immobilization - brace
PWB with crutches
PRICE
taping/bracing
NMES
ROM, strengthening,

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16
Q

femoral condyle fracture

A

MOI- axial loading fall or MVA

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17
Q

femoral condyle fx treatments

A

traction or bracing

surgery

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18
Q

femoral condyle fx rehab

A

immobilization
non-weight bearing 3 mo
patient education
ROM
strengthening

prognosis up to a 1 yr

19
Q

epiphyseal complex fx

A

pediatric fx
on any long bone

MOI- direct trauma with rotation, hyperextension, valgus stress

5 types
2 is most common
5 is least common and most severe

20
Q

salter harris 1

A

S
separated growth plate

21
Q

salter harris 2

A

A
above growth plate
most commonn

22
Q

salter harris 3

A

L
below growth plate

23
Q

salter harris 4

A

T
through growth plate

24
Q

salter harris 5

A

ER
erasure of growth plate
least common
most severe

25
Q

which salter harris types do well without surgery

A

1 and 2
often immobilized in long leg casts with hip and foot
4-6wks

26
Q

which SH type may result in malalignment

A

4

27
Q

which SH may result in arrest of bony growth

A

5

28
Q

tibial spine fracture

A

intra articular fx

most common in children at 8-14 years old

MOI - rapid acceleration or hyperextension/rotation
Fall from bike very common

Other injuries that can occur at the same time
Osteochondral fracture
ligament injury
Femoral condyle or tibial plateau fracture

29
Q

tibial spine fx treatment

A

non-operative for nondisplaced fractures

Surgery for displaced and comminuted fractures

30
Q

tibial spine fx rehab

A

immobilization
Weight-bearing restrictions
Education
ROM
Strengthening

Prognosis - usually within six months

31
Q

Tibial tubercle fracture

A

most common in adolescence
Males >females
Less than one percent of pediatric fractures

MOI - strong contraction of quads while jumping or during forced knee flexion

32
Q

tibial tubercle fracture treatments

A

non-operative for non-displaced or closed reduction injuries

Surgery for displaced or more involved injuries - immobilization

33
Q

tibial tubercle fracture rehab

A

cast immobilize
Weight-bearing restrictions
Education
ROM
Strengthening

Prognosis- within six months

34
Q

tibial plateau fracture MOI

A

axial loading fall or MVA

35
Q

Tibial plateau fracture rehab

A

immobilization as needed
Nonweightbearing up to three months
Patient education
ROM
Strengthening

Prognosis - complications are not uncommon. Moderate functional outcomes are achieved may take greater than a year and increased risk of OA

36
Q

Tibial plateau fracture treatments

A

traction or casting
Often less desirable due to inactivity

Surgery
Lots of options

37
Q

segond fx

A

avulsion fracture of lateral aspect of the tibial plateau
Often occurs in conjunction with ACL injuries

MOI- most commonly occurs via forceful, internal rotation and varus stretch
Different from common MOI for ACL

38
Q

segond fx treatments

A

Address under my injury, most commonly the ACL injury

Surgery for segond fracture may help with rotary stability

39
Q

segond fx rehab

A

symptoms management
Protect knee early on
If surgery is performed, follow protocol

40
Q

tibiofemoral disocation

A

MOI- severe traumatic injury

Rare .02% of orthopedic injuries

41
Q

tibiofemoral dislocation treatment

A

imaging and neurovascular assessment
Reduction
reassessment of neurovascular integrity
Extensive surgery is often needed to reconstruct multiple injuries

42
Q

tibiofemoral dislocation common complications

A

Neurovascular damage
avascular necrosis
persistent weakness
Persistent stiffness
Tibiofemoral instability
Patellar instability
Arthritis

43
Q

physical therapist role during immobilization

A

Minimal visits
Safe return to function
Protect injured and uninjured tissues

MSK 2 test 1 (11 decks)

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