Lecture 5 - Conditions of the Leg

Question 1

Tibia Fractures MOI:

Answer 1

Rotation while weight bearing , boot top, fatigue/stress

Question 2

Types of fractures for tibia

Answer 2

Condylar (10-12 weeks)
Shaft (16+ weeks)
Avulsion of med malleolus (10-12 weeks)

Question 3

Signs and symptoms of a tibia fracture

Answer 3

Pain
+ XRay
Gross instability/ deformation

Question 4

Treatment for tibia fractures

Answer 4

stabilize
activate EAP
treat for shock

Question 5

MOI for fibula fractures

Answer 5

rotation while weight bearing
sprain/avulsion (common)
direct blow (common)
fatigue/stress

Question 6

Fracture type for fibula fractures + recovery time

Answer 6

Shaft fracture (4 weeks)
Avulsion of lat malleolus (10-12weeks)
Spiral fracture (depends(

Question 7

What is more common a fibula or tibia fracture?

Answer 7

A fibula fracture but they are less serious compared to a tibia.
The fibula can also be impacted when a tibia is fractured

Question 8

Signs and symptoms of a fibula fracture

Answer 8

NWB or PWB
Pain
+ X-ray
positive tuning fork test

Question 9

Treatment for fibula fracture

Answer 9

stabilize
refer for x-ray
crutches where applicable

Question 10

Stress fractures MOI

Answer 10

An increase in training, muscle fatigue/imbalance, slow bone remodeling
Training surfaces also play a role

Question 11

Structures affected with a stress fracture

Answer 11

Tibia, and bones of the foot

Question 12

Stress fractures signs and symptoms

Answer 12

Intial xray must be negative
pain with activity
mid season
compartment syndrome
pain over medial crest

Question 13

treatment for a stress fracture

Answer 13

decrease activity level
address surrounding muscles
adjust training surface if possible
may have to examine footwear

Question 14

Leg strain MOI

Answer 14

see strains under eccentric load

Question 15

Structures affected with a leg strain

Answer 15

Gastrocnemius, tibialis anterior, peroneals.

Question 16

How is the Gastronemius affected by a leg strain?

Answer 16

Running uphill, cutting, planting , jumping (landing)

poor warmup/foot wear

Question 17

How is the Tibialis Anterior affected by a leg strain?

Answer 17

Down hill running
Poor arch support/ footwear
Compartment syndrome
Poor warm up

Question 18

How is the Peroneals affected by a leg strain?

Answer 18

• Secondary to inversion ankle sprain
• Cutting planting
• Needs to be stregthened in rehab/prehab to avoid inversion injuries

Question 19

Rupture of Ticeps Surae Complex MOI

Answer 19

Explosive plantar flexion/landing from a jump

Occurs at the MT junction

Question 20

Structures affected with rupture of Ticeps Surae Complex

Answer 20

Calcaneal (achillies) tendon

Question 21

Signs and symptoms rupture of Ticeps Surae Complex

Answer 21

• pt. hear a pop
• often divot/deformity
• must be seen quickly (swell)
• bunching of muscle belly
• pain w/loss of function

Question 22

Treatment for rupture of Ticeps Surae Complex.

How long in rehab?

Answer 22

• surgical intervention
• initial splinting post-op in plantar flexion
• progressive rehab back to neutral
• Rehab is usually -1 year RTS

Question 23

What special test do you use for rupture of Triceps Surae Complex? What does it do?

Answer 23

The Thompson Test

It performs passive compression of the calf muscles

Question 24

Leg contusions MOI:

Answer 24

-Impact for a variety of reasons, muscles of the leg are all prone to contusions from direct trauma

Question 25

Treatment of leg contusion

Answer 25

• As per contusion*

- Pressure and elevation with buttress.

Question 26

Compartment Syndrome

MOI:

Answer 26

-Tightness in compartment due to excess swelling, infection,
hypertrophy, or a combination of.

Question 27

Compartment Syndrome structures affected

Answer 27

-Muscles A/V/N in compartment

Question 28

Signs and symptoms compartment syndrome ( the five p’s)

Answer 28

• red hot SHINY skin
  -pain with passive stretch
  -paresthesia/hypoesthesia
  -paralysis
  -palpable swelling
  peripheral pulses absent