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)
