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)

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7.Knee injury ( Diagnosis???)

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7 knee injury diagnosis

7.Knee injury( Diagnosis???)


7 knee injury

7.Knee injury

  • ACL,PCL,MCL injury -common

  • fracture

  • Contact sport


Knee anatomy

Knee anatomy

3 bone

Patella

Tibia

femur


1 ligament

1.Ligament

1.Anterior cruciate ligament(ACL)

2.Posterior cruciate ligament(PCL)

3.Medial collateral ligament(MCL)

4.Lateral collateral ligament(LCL)


2 meniscus

2.meniscus

Medial, lateral meniscus

function

1.Transmit load and distribution

2.Increase contact surface area


Knee anatomy1

Knee anatomy


Mechanism injury

Mechanisminjury

Pivot sport ( soccer , basketball rugby)

Decelerate, jumping

Hyperextend

rotate

Pop sound ( ACL torn)


Clinical

Clinical

Pain ,cannot walk

Swelling

hematrosis


Knee exam

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

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


2 varus stress test lateral collateral ligament lcl

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.Lachman test for ACL (Anterior cruciate ligament)


3 anterior drawer test adt for acl anterior cruciate ligament

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


7 knee injury diagnosis

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


Treatment

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)


7 knee injury diagnosis

Ligament Reconstruction

ACL Reconstruction


7 knee injury diagnosis

Post operation

-Hinge knee brace

-Axillary crutch


Meniscus injury

Meniscus injury


Meniscus tear

Meniscus tear


Arthroscopic repair

Arthroscopic repair


Arthroscopic repair1

Arthroscopic repair


8 leg injury

8.Leg injury

  • Diagnosis ??


Anatomy leg

Anatomy leg

  • 2 bone

  • 1.Tibia ( weight bearing)

    Tibia plateau – proximal (knee)

    Tibia plafond – distal

    (ankle)

  • 2.Fibula (non weight bearing)


8 leg injury1

8.Leg injury

  • Common

  • Twist , direct injury

  • Contact sport( soccer,rugby)


8 1fracture tibia and fibula

8.1Fracturetibia and fibula

  • Severe pain

  • Deformity

  • Shortening

  • Aware open fracture

    (Emergency)

  • Neurovascular


Treatment1

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 Intramedullary Nail(tibia)


Surgery with external fixator in dirty open fracture tibia

Surgery with External fixator in dirty open fracture tibia


Diagnosis

Diagnosis ???


8 2 muscle cramp

8.2 Muscle cramp

  • Common injury

  • Calf pain, tender

  • Cause – electrolyte imbalance

    - dehydration

    - muscle contraction imbalance


8 2 muscle cramp1

8.2 Muscle cramp

Muscle contraction imbalance


Treatment2

treatment

  • Passive stretching

  • IV fluid

  • Check electrolyte


9 ankle injury

9.Ankle injury

  • Diagnosis???


Ankle anatomy

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 anatomy1

Ankle anatomy


9 ankle injury1

9.Ankle injury

  • Most common

  • Twist, direct injury

  • Soccer,basketball

  • 1.ligament injury

    -Inversion lateral ankle sprain

  • 2.Fracture ankle


9 1 ankle sprain

9.1 Ankle sprain

  • Mechanism injury

  • Inversion (common)

  • Lateral injury ,tear

  • Pain

  • Swelling

  • Cannot walk


Ankle sprain

Ankle sprain


Treatment3

Treatment

  • On field

    - RICE

  • Definite treatment depend on grade of injury


Grading of ankle sprain

Grading of ankle sprain

  • Grade 1 (mild) – pain,tender

  • Grade 2 (partial tear)

    - pain ,swelling

    - marked tender

    - good stability


Treatment in grade 1 2

Treatment in Grade 1,2

  • Ankle support

  • Brace

  • Elastic bandage

  • Splint (2-6 week)


Grade 3 complete tear

Grade 3 (complete tear)

  • Marked pain,swelling

  • Instability

  • Cannot walk

    Treatment

  • 1.brace, cast

  • 2.surgery if instability or chronic


9 2 fracture ankle

9.2 Fracture ankle

  • Tender,pain,swelling

  • Deformity

  • Aware open fracture

  • Neurovascular – post tibia a,n


Fracture ankle

Fracture ankle


Treatment4

treatment

  • 1.On field - splint

  • Reduction if marked deformity

    - Direct traction for prevent neurovascular

  • 2. Surgery

    ( 8-12 week)


Rehabilitation

Rehabilitation

  • ROM

  • Strength

  • resist


Thank you

THANK YOU

Question ???


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