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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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Presentation Transcript
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

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
2 varus stress test lateral collateral ligament lcl
2.Varus stress test – lateral collateral ligament ( LCL)
  • Varus stress test in flex 30,full extend
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)

slide17
Ligament Reconstruction

ACL Reconstruction

slide18
Post operation

-Hinge knee brace

-Axillary crutch

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)

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

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
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
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 ???