Lower Limb Injuries Flashcards
State 2 types of hip/groin injuries.
Acute injury. Osteitis pubis. Piriformis syndrome. Femoracetabular impringement. Tendinopathy. Athletic pubalgia.
What classification is used for a femoral neck fracture?
Garden classification.
What are the different aspects of the Garden Classification for a femoral neck fracture?
Type 1 - Stable (Valgus - outward angulation of the distal segment of a bone). Non-displaced. Complete: partially displaced. Complete: fully displaced.
Type 2 - Non-displaced
Type 3 - Complete: partially displaced
Type 4 - Complete: fully displaced
What are the different aspects of the Functional Classification?
Stable (I/II). Unstable (III/IV).
Give 2 examples of acute injuries.
Tendon strain. Stress fracture. Trochanteric pain syndrome. Labral tear.
Where do you find acute injuries for hips/groins?
In athletes and active adults.
What is a stress fracture?
Fatigue induced fracture of the bone due to repeated stress.
What is trochanteric pain syndrome?
Trochanteric bursitis - inflammation in the muscles/tendons/fascia/bursae.
Define a labral tear.
Injury to the labrum - soft tissue that covers the acetabulum (socket) of the hip.
Define osteitis pubis.
Idiopathic, inflammatory disease of pubic symphysis.
Define piriformis syndrome.
When the piriformis muscle located in the buttock region spasms- buttock pain. Piriformis muscle can also irritate the sciatic nerve - pain, numbness, tingling along the back of leg and into foot.
Define femoracetabular impringement.
Extra bone grows along one/both of bones that form hip joint. Bone gets irregular shape and rubs against each other during movement.
Define tendinopathy.
Tendon disorder resulting in pain, swelling and impaired function.
Define athletic pubalagia.
Refers to sports hernia (painful soft tissue in groin area).
State the management of a femoral shaft fracture.
Start IV fluids. Send bloods. Analgesia.
State 3 knee injuries.
Knee soft tissue injury. Fractured patella. Patella dislocation. Segond fracture. Fracture of the tibial condyle.
State a sign of a knee soft tissue injury.
Wasting. Deformity. Swelling. Bruising.
State 1 thing to be ruled out with a knee soft tissue injury.
Quadriceps tear.
State a test used to rule out a quadriceps tear.
Use Movement - McMurray’s test/Drawer test/Lachaman’s test.
What knee rule is used to determine whether radiography should be used?
Ottawa’s knee rule.
State 2 parts to Ottawa’s knee rule.
Aged 55 or older. Isolated tenderness to patella (not anywhere else). Tenderness at the head of the fibula. Inability to bear weight.
Describe the anterior drawer test.
Physical examination used to test the stability of the knee’s anterior cruciate ligament (ACL) - anterior force applied to the tibia.
What is a positive anterior drawer test?
If the tibia has more movement/ligament more loose compared with the other knee.
State the management of an undisplaced patella.
Bandage.
State the management of a displaced patella.
Fixation required.
State the management for a patella dislocation.
Analgesia - nitrous oxide. X-ray to exclude osteochondral fracture.
Define a segond fracture.
Fracture on the lateral aspect of the proximal tibia, below the articular surface area.
State associated injuries to the segond fracture.
Tear of the anterior cruciate ligament. Injury of the medial and lateral menisci (fibrocartilage which serve to disperse the friction in the knee). Avulsion (detachment of a bone fragment) fracture of the fibular head.
State another name for a fracture of the tibial condyle.
Tibial plateau fracture.
State 2 injuries related to the tibia (leg).
Fracture of the tibial shaft. Fracture of the fibula shaft. Pretibial lacerations. Compartment syndrome.
State one place you would find a pretibial laceration?
Elderly. Poor blood supply.
State one thing to exclude with a fracture to the fibula shaft.
Exclude common peroneal injury (if at neck). Exclude compartment syndrome.
Define compartment syndrome.
When there is increased pressure with one of the body’s anatomical compartments - results in insufficient blood supply to tissue within space (therefore swelling/damage to muscles/nerves).
State a symptom of compartment syndrome.
Paresthesia (pins/needles). Pallor (pale appearance). Paralysis. Pulselessness.
State 2 things that can happen to ankles.
Ankle sprains (80% inversion). Ankle fractures. Tendoachilles tear. Fracture of calcis (heel bone).
State a ligament affected in an ankle sprain.
Anterior talofibular ligament. Calcaneofibular ligament. Talofibular ligament.
What classification is used for ankle fractures?
Weber’s classification.
State the types of Weber’s classification.
1) Type A - fractured tip of lateral malleolus
2) Type B - undisplaced fracture of the lateral malleolus (high up)
3) Type C - undisplaced fracture of the lateral malleolus and undisplaced transverse fracture of the medial malleolus.
State the test used to determine a tendoachilles tear.
Simmond’s test - normally when you squeeze the calf it should produce plantar flexion.
State the angle measured to determine fracture of the calcis (heel bone).
Boehler’s angle (if less than 20 degrees then fracture likely).
State the angle measured to determine fracture of the calcis (heel bone).
Boehler’s angle (if less than 20 degrees then fracture likely).
State the angle measured to determine fracture of a .
Boeher’s angle.
State the most commonest metatarsal to be fractured.
Base of the fifth metatarsal.
State the two main types of metatarsals.
Jones fracture (involves 5th metatarsals) - occur at the metaphyseal-diaphyseal junction. Pseudo jones fracture (5th metatarsal base).
Define the Jones fracture.
Occurs at the metaphyseal-diaphyseal 4th and 5th junction.
State when a Jone’s fracture would be experienced.
Force applied when heel raised and foot plantar flexion.
State where a Pseudo Jones fracture is experienced.
5th metatarsal base.
State when a Pseudo Jone’s fracture would be experienced.
Inversion and plantar flexion. Involves proximal tubercle.
Define a Lisfranc fracture.
A fracture where one of metatarsals is displaced.
