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Clinical Interventions > Lower Leg conditions > Flashcards

Lower Leg conditions Flashcards

1
Q

What is the most commonly fractured long bone in the body?

A

tibia

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2
Q

What is the MOI of fibular fractures?

A

Trauma in combo with tibial Fx

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3
Q

What is the presentation of tibial Fx?

A

pain, swelling, possible deformity

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4
Q

What is the presentation of fibula Fx?

A

TTP and pain with ambulation

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5
Q

How long is rehab for a non-displaced tibial Fx?

A

10-13 weeks

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6
Q

How long is rehab for a displaced tibial Fx?

A

16-26 weeks

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7
Q

How long is rehab for a fibula Fx?

A

4-6 weeks

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8
Q

What is the common location on the tibia that tibial STRESS Fx occur?

A

mid-anterior aspect (jumping) and posteromedial aspect of the tibial shaft

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9
Q

What is the MOI of tibial/fibular stress Fx?

A
  • repetitive loading during training that the bone cannot adapt to
  • WB training
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10
Q

What is the presentation of an anterior tibial stress Fx?

A
  • activity relieved with rest
  • anterior pain
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11
Q

What is the presentation of a posteromedial tibial stress Fx?

A
  • pain over the distal 1/3
  • gradual symptom onset
  • TTP
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12
Q

What is the presentation of a fibular stress Fx?

A
  • pain/TTP on the distal 1/3 of the bone
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13
Q

What are rehab concerns for tibial and fibular stress Fx?

A
  • stop activity IMMEDIATELY
  • pt education on rest and stress significance
  • maintain CV fitness with stationary cycling and water walking
  • address footwear
  • address imbalances
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14
Q

What type of tibial stress Fx take longer to heal and has a high prevalence of continued issues?

A

Mid-anterior tibial stress Fx
- short leg cast for 6-8 weeks
- surgery

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15
Q

definition: increased pressure within a fixed osteofascial compartment causes compression of muscular and neurovascular structures within the compartment

A

compartment syndrome

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16
Q

What happens to venous and arterial flow with compartment syndrome?

A

They stop (venous then arterial)

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17
Q

What is the presentation of acute compartment syndrome?

A
  • deep aching pain
  • tightness
  • swelling of involved compartment
  • reduction on foot pulses
  • sesnory change with involved nerve
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18
Q

What are aggs for acute compartment syndrome?

A

Passive stretching of involved muscles

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19
Q

What confirms a Dx for compartment syndrome?

A

intracompartmental pressure

20
Q

What is the definitive treatment for acute compartment syndrome and acute exertional compartment syndrome?

A

emergency fasciotomy

21
Q

What type of compartment syndrome occurs without any precipitating trauma and evolves with minimal to moderate activity?

A

Acute exertional compartment syndrome

22
Q

What type of compartment syndrome Is activity-related in that the symptoms arise rather consistently at a certain point in the activity?

A

chronic compartment syndrome

23
Q

What is the presentation of chronic compartment syndrome?

A
  • sensation of pain and tightness
  • swelling of affected compartment that resolves with stopping activity
24
Q

What compartments most commonly have chronic compartment syndrome?

A

Anterior and deep posterior

25
Q

Do males or females respond better to fasciotomies to treat compartment syndrome?

A

males

26
Q

Anterior compartment fasciotomy patients may not return to full activity until ___-___ weeks after surgery

A

8-12 weeks

27
Q

Deep posterior compartment fasciotomy patients may not return to full activity until ___-___ weeks after surgery

A

3-4 weeks

28
Q

What is the most common muscle strain in the lower leg?

A

Gastrocnemius

29
Q

What is the typical patient presentation with a gastrocnemius muscle strain?

A
  • feel/hear a pop
  • pain
  • may not be able to walk due to DF stretch and no push-off
  • TTP/divot may be present if there’s a rupture
30
Q

definition: a condition that involves increasing pain about the distal two-thirds of the posterior medial aspect of the tibia.

A

Medial tibial stress syndrome (Shin splints)

31
Q

What is the presentation of medial tibial stress syndrome?

A
  • diffuse pain on the distal medial tibia and surrounding soft tissues
  • excessive PRON
  • tender
  • may ONLY hurt after a workout
  • pain with daily ambulation
  • morning pain and stiffness
32
Q

What is the MOI of medial tibial stress syndrome?

A

greater tensile loads
- excessive/rapid PRON
- PRON at wrong time in stance phase
- rearfoot and forefoot varus
- overuse of PF

33
Q

How long should a person with medial tibial stress syndrome not run or jump?

A

7-10 days

34
Q

definition: inflammatory condition that involves the Achilles tendon and/or its tendon sheath

A

achilles tendinitis

35
Q

What is the typical presentation of achilles tendinitis?

A
  • pain and stiffness
  • agg with uphill running/hill workouts/interval training
  • reduced gastroc and soleus flexibility
  • muscle testing can be WNL but can present with pain
  • gradual onset
  • stiffness and discomfort with gait after prolonged sleeping and sitting
  • excessive compensatory PRON
36
Q

What is the largest tendon in the body?

A

achilles

37
Q

What does the achilles tendon do?

A

transmits force from gastroc and soleus to the calcaneus

38
Q

Tension through the achilles tendon in terminal stance is ____% of body weight

A

250%

39
Q

Where is the typical location of an achilles tendon rupture?

A

2-6 cm proximal to the calcaneal insertion (avascular site)

40
Q

What is the typical presentation of an achilles tendon rupture?

A
  • popping
  • PF is painful and limited
  • palpable defect
    (+) thompson
41
Q

What are the MOIs for achilles tendon ruptures?

A
  • sudden, forceful PF of the ankle (jumping/running)
  • associated compensatory PRON for STJ
  • inflexibile gastroc-soleus complex
  • fatigue
42
Q

Those with an achilles tendon rupture should be immobile for the first __–___ weeks post-op

A

6-8 weeks

43
Q

definition: is a disc-shaped sac that lies between the Achilles tendon and the superior tuberosity of the calcaneus

A

retrocalcaneal bursa

44
Q

What is the presentation of retrocalcaneal bursitis?

A
  • gradual onset
  • pain with AROM/PROM of ankle DF
  • RELIEF with PF
  • painful during gait due to DF in the midstance of gait and muscle activity of the PFs during push-off
45
Q

What causes retrocalcaneal bursitis?

A
  • loading the foot and ankle in repeated DF
  • structural abnormalities

Clinical Interventions (25 decks)

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