Ligament & Joint Lecture (Clinicals & Important Topics) Flashcards
Hip Dislocation (Most common direction of dislocation and symptoms)
- Posteriorly because the Ischiofemoral L. is the weakest of all hip ligaments
- FLEXED HIP is also more susceptible to injury
- Symptoms:
1) Shortened leg
2) Internally rotated leg
3) Slightly Adducted
Other:
- An orthopaedic emergency, especially with native bone and in the young
- Associated with other complications since the hip joint has numerous tendons, ligaments, arteries and nerves going through (known as a “Complex hip dislocation) when these other structures are impacted)
Hip Fracture
- Can be deadly in the elderly
- In the young - immediate surgery due to possibility for avascular necrosis (cutting off of retinacular arteries)
Symptoms:
1) Shortened leg
2) Externally rotated leg (different from a dislocation with is IR)
Calcar Femorale
A dense bone that is vertically orientated in the head of the femur and is important for:
1) Arthroplasty and prostetcis due to its solidity
2) Can help differentiate fracture patterns
Trendelenberg Gait
Deficiency in the hip abductors and glutius medius and minimis (superior gluteal nerve)
What is a CAM Impingement?
When the femoral head begins growing excess mbone that starts to impinge hip movement
What is a Pincer Impingement?
The Acetabulum (rim) begins growing extra bone that prevents full range of motion for the femur (opposite of CAM)
Bipartite Pallela
- Failure of the superolateral part of the patella to fuse with the rest of the patella
- Usually asymptomatic
- Often mistaken for a fracture
- Common in 8% of population and 50% of the time it is bilateral
Segond Fracture
An excess rotation at the knee that results in the avulsion of bone where the Anterolateral L. attaches
-ACL will often tear as well
Sprain Severity Scale
1) Normal
2) Grade 1 - slight overstretching/tearing
3) Grade 2 - partial/large tear
4) Grade 3 - full rupture/tear
MCL Injuries
- Most common MULTI-Ligament injury
- 40% of knee injuries
- ACL will usually also tear
What is the O’Donoghue Unhappy Triad?
Tear of the:
1) ACL
2) MCL
3) Meniscus
Meniscal Tear
- Most common reason for surgical intervention on knee
- Since it stabilizes the knee, injury leaves the ACL susceptible to injury
- Blood greater to the exterior so injury to the more medial part of the meniscus is more difficult to repair
- Lateral portion is more stable than the middle due to excursion, permits more movement
PCL Injury
- 5-10% of knee injuries
- Tibia will sag posteriorly
- Commonly UNDIAGNOSED
- Caused by:
- Hit to anterior knee
- Fall on flexed leg, plantarflexed foot
- Hyperextension
ACL Tear
- 400,000 surgeries on this per year
- Women 3-5x more likely to get because of:
- Lower BMI
- Smaller ACL
- Quad-dominant
- Lesser core strength
What Dynamic and Passive elements make up the Transverse Arch?
Plantar ligaments (forefoot)
Tibialis Posterior (metatarsal arch)
Flexor Hallucis Longus (tarsal arch)
Fibularis Longus (tarsal arch)
What dynamic and passive elements make up the Longitudinal Arch?
Dynamic
- Tibilais posterior
- tibialis anterior
- flexor hallucis longus
- fibularis longus
- Intrinsic foot muscles
Passive
Long plantar L
Short Plantar L
Spring L.
Plantar Aponeurosis
Pes Transversoplanus
Breakdown of the transverse arch (forefoot will become flatter to the ground)
Pes Planus
aka flat feet or fallen arches (in children)
-Medial part of the Longitudinal Arch drops
Cause:
- Plantar L. and Aponeurosis become abnormally streched
- Spring Ligament can no longer support Talar head
Potts Fracture-Dislocation
Caused by hard and fast pronation/abduction, resulting in:
1) Fracture of Medial Malleolus
2) Fracture of Fibula
3) Tear of ATF
Ankle Sprains
Primarily inversion injury
Most commonly injured joint
- Anterior Tibiofibular L (most common)– also lateral ankle sprain
- High ankle sprain
Tibiofibular Syndesmosis
- Anterior Tibiofibular L.
- Posterior Tibiofibular L.
- Interosseous Membrane
Where does a foot amputation typically occur?
Along the Transverse Tarsal Joint
Calcaneocuboid Joint
Talonavicular Joint
