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1. MSK > Leg Injuries > Flashcards

Leg Injuries Flashcards

1
Q

What parts of the extensor mechanism can rupture?

A

patella tendon rupture - <40yrs
quads tendon rupture - >40yrs
rectus femoris rupture
patella fracture

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2
Q

How is the extensor mechanism commonly injured?

A

fall onto a flexed knee with quads contraction

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3
Q

How would an extensor mechanism injury present?

A

unable to straight leg raise, palpable gap

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4
Q

What risk factors can predispose to extensor mechanism injury?

A

patellofemoral OA
previous tendonitis
chronic renal failure
steroid injections into tendons

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5
Q

How are extensor mechanism ruptures investigated and treated?

A

Xray or ultrasound
patella low lying on xray: qauds rupture
patella high lying on xray: patella tendon rupture
surgical repair

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6
Q

What would be the problem if there was no trauma and the patient could not straight leg raise?

A

femoral nerve problem

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7
Q

How are meniscal tears investigated?

A

MRI

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8
Q

What do radial tears lead to?

A

parrot beak tears

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9
Q

What do longitudinal tears lead to?

A

bucket handle tears

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10
Q

What is the risk with bucket handle tears?

A

part of the knee can displace anteriorly or into the intercondylar notch meaning the KNEE LOCKS

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11
Q

What do horizontal tears lead to?

A

flap tears

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12
Q

What does an acute locked knee show?

A

displaced bucket handle tear
patient will still have a 15 degree springy block
requires URGENT SURGERY

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13
Q

What are more common: medial or lateral meniscal tears?

A

medialx10

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14
Q

What is the treatment for meniscal tears?

A

limited due to there only being a blood supply to the outer third
longitudinal tears involving the outer third in young patients should get surgical repair

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15
Q

What is the unhappy triad?

A

damage to MCL, ACL and medial meniscus

- due to lateral impact and valgus stress

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16
Q

What way would a patella commonly dislocate: laterally or medially?

A

laterally

17
Q

What is the treatment for a patella dislocation?

A

may spontaneously reduce when the knee is straightened or may need to be manually manipulated back into position

18
Q

What may patella dislocation result in?

A

patellafemoral ligament tears

osteochondral fracture of the lateral femoral epicondyle

19
Q

Which people are more at risk of a patella dislocation?

A

females
increased laxity
shallow trochlear groove
genu valgum

20
Q

When would an ACL rupture take place?

A

due to rotatory instability

knee giving way on turning

21
Q

What is the classic presentation of an ACL rupture?

A

knee swelling
haemarthrosis and effusion
excessive anterior translation of the tibia on the anterior drawer test/Lachmanns test

22
Q

What is the ACL rule of 1/3rd?

A

1/3rd will compensate and do whatever they want
1/3rd will compensate but wont be able to do sports
1/3rd will not compensate and will need to have surgery

23
Q

What is the treatment for ACL ruptures?

A 
physiotherapy to strenghten muscles
surgical reconstruction (tendon transfer) for those who cant compensate
24
Q

When would a PCL rupture happen?

A

motorbikes

RTA

25
Q

What is the common presentation of an MCL tear?

A

laxity and pain on valgus stress

tenderness over the origin/insertion of the MCL

26
Q

What is the treatment for MCL tears?

A

Acute: knee hinge brace
Chronic: MCL reconstruction or tightening

27
Q

What is the common presentation of LCL tears?

A

instability on rotating

look varus and hyperextended

28
Q

What nerve can commonly be damaged due to LCL tears?

A

peroneal nerve - due to excessive stretch

29
Q

What is myositis ossificans?

A

abnormal calcification of the muscle haematoma forming a hardness over a previously injured area

30
Q

How is myositis ossificans diagnosed?

A

Xray

MRI

1. MSK (36 decks)

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