7 knee injury diagnosis
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7.Knee injury ( Diagnosis???) PowerPoint PPT Presentation


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7.Knee injury ( Diagnosis???). 7.Knee injury. ACL,PCL,MCL injury -common fracture Contact sport. Knee anatomy. 3 bone Patella Tibia femur. 1.Ligament. 1.Anterior cruciate ligament(ACL) 2.Posterior cruciate ligament(PCL) 3.Medial collateral ligament(MCL)

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7.Knee injury ( Diagnosis???)

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7.Knee injury( Diagnosis???)


7.Knee injury

  • ACL,PCL,MCL injury -common

  • fracture

  • Contact sport


Knee anatomy

3 bone

Patella

Tibia

femur


1.Ligament

1.Anterior cruciate ligament(ACL)

2.Posterior cruciate ligament(PCL)

3.Medial collateral ligament(MCL)

4.Lateral collateral ligament(LCL)


2.meniscus

Medial, lateral meniscus

function

1.Transmit load and distribution

2.Increase contact surface area


Knee anatomy


Mechanisminjury

Pivot sport ( soccer , basketball rugby)

Decelerate, jumping

Hyperextend

rotate

Pop sound ( ACL torn)


Clinical

Pain ,cannot walk

Swelling

hematrosis


Knee Exam

  • Deformity

  • Swelling , ballotment

  • Tender - joint line

  • ROM – Flex,extend

  • Muscle –quadricep

  • Special test for ligament


1.Valgus stress test – Medial collateral ligament ( MCL)


2.Varus stress test – lateral collateral ligament ( LCL)

  • Varus stress test in flex 30,full extend


3.Lachman test for ACL (Anterior cruciate ligament)


3.Anterior drawer test (ADT) for ACL (Anterior cruciate ligament)


  • 4.Posterior drawertest for.Posterior cruciate ligament (PCL)


treatment

  • On – field

    - RICE ( ligament injury)

    - splint ( fracture)

  • Ligament injury

    - long leg cast (MCL) 4-6week

    - surgery – 1.Repair

    - 2.Reconstruction

    ( 6 week – 6 month)


Ligament Reconstruction

ACL Reconstruction


Post operation

-Hinge knee brace

-Axillary crutch


Meniscus injury


Meniscus tear


Arthroscopic repair


Arthroscopic repair


8.Leg injury

  • Diagnosis ??


Anatomy leg

  • 2 bone

  • 1.Tibia ( weight bearing)

    Tibia plateau – proximal (knee)

    Tibia plafond – distal

    (ankle)

  • 2.Fibula (non weight bearing)


8.Leg injury

  • Common

  • Twist , direct injury

  • Contact sport( soccer,rugby)


8.1Fracturetibia and fibula

  • Severe pain

  • Deformity

  • Shortening

  • Aware open fracture

    (Emergency)

  • Neurovascular


treatment

  • On-field

    – long splint ,transport

    - clean wound

  • Definite

    - long leg cast 10-12 week

    - Surgery in displaced fracture

    ( 3-6 month)


Surgery with Intramedullary Nail(tibia)


Surgery with External fixator in dirty open fracture tibia


Diagnosis ???


8.2 Muscle cramp

  • Common injury

  • Calf pain, tender

  • Cause – electrolyte imbalance

    - dehydration

    - muscle contraction imbalance


8.2 Muscle cramp

Muscle contraction imbalance


treatment

  • Passive stretching

  • IV fluid

  • Check electrolyte


9.Ankle injury

  • Diagnosis???


Ankle anatomy

  • 3 bone

    1.distal tibia,medial malleolus

    2.distal fibula,lateral malleolua

    3.talus

  • Ligament

    1.medial – deltoid ligament

    2.lateral – ATFL,PTFL,CFL


Ankle anatomy


9.Ankle injury

  • Most common

  • Twist, direct injury

  • Soccer,basketball

  • 1.ligament injury

    -Inversion lateral ankle sprain

  • 2.Fracture ankle


9.1 Ankle sprain

  • Mechanism injury

  • Inversion (common)

  • Lateral injury ,tear

  • Pain

  • Swelling

  • Cannot walk


Ankle sprain


Treatment

  • On field

    - RICE

  • Definite treatment depend on grade of injury


Grading of ankle sprain

  • Grade 1 (mild) – pain,tender

  • Grade 2 (partial tear)

    - pain ,swelling

    - marked tender

    - good stability


Treatment in Grade 1,2

  • Ankle support

  • Brace

  • Elastic bandage

  • Splint (2-6 week)


Grade 3 (complete tear)

  • Marked pain,swelling

  • Instability

  • Cannot walk

    Treatment

  • 1.brace, cast

  • 2.surgery if instability or chronic


9.2 Fracture ankle

  • Tender,pain,swelling

  • Deformity

  • Aware open fracture

  • Neurovascular – post tibia a,n


Fracture ankle


treatment

  • 1.On field - splint

  • Reduction if marked deformity

    - Direct traction for prevent neurovascular

  • 2. Surgery

    ( 8-12 week)


Rehabilitation

  • ROM

  • Strength

  • resist


THANK YOU

Question ???


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