04 Knee Special Tests: PCL Flashcards Preview

7232 Ortho > 04 Knee Special Tests: PCL > Flashcards

Flashcards in 04 Knee Special Tests: PCL Deck (23):
1

What are the clusters of s/s for PCL tests?

- hx macrotrauma
- hyperextension injury
- fall on anterior tibia with ankle in plantarflexion
- intra-articular effusion
- suspected ACL

2

example of a hyperextension injury

dashboard injury

3

Why do the PCL tests if you suspect ACL?

do the tests for each together

4

For PCL tests, how much should the knee be flexed?

less than 90˚

5

Why must you flex the knee to less than 90˚ in PCL tests?

- meniscus will become wedged and block anterior motion
- patient will have effusion

6

What does the recurvatum test for PCL test?

- PCL
- posterior capsule

7

PCL: recurvatum test procedure

- supine
- stabilize distal femur with one hand and grab ankle with other
- pull up on ankle 3x, hyperextending the knee

8

for the PCL recurvatum test, what is normal?

5-10˚ recurvatum

9

PCL: sag test procedure

- flex knee to 70-80˚
- look at knee from the side

10

What is a positive sag test?

- concavity from the inferior pole of patella to tibial tuberosity
- PCL is torn

11

What is happening to the tibia in a positive sag test?

tibia will sag posteriorly

12

Evidence for the Clancy step-up test

- no evidence
- Davies says this one gives him a good idea of where the tibia is sitting

13

Clancy step-up test position

- sit on foot to stabilize
- hands in SRP
- IP joints line up with joint line
- flex IP joints

14

What are you palpating in addition to the tibia for the Clancy Step-Up test?

hamstrings
- make sure they aren't contracting them
- seeing if there's spasm

15

What should you feel in the Clancy step-up test when you flex the thumbs?

should feel a 10 mm step up of the tibia toward you relative to the femur

16

What will you feel with a positive Clancy step-up test?

femur feels closer than 10 mm to the edge of the tibia

17

What does a positive Clancy step-up test mean?

means it's subluxated posteriorly

18

posterior drawer test: What is this for?

PCL

19

posterior drawer test procedure

- hands in same position as Clancy step-up
- SRP is neutral if tibia isn't sagged back
- straighten elbows, pushing tibia straight back

20

posterior drawer test: What would happen if there's a PCL tear?

tibia subluxates posteriorly

21

posterior drawer test: Which types of PCL tears are often missed and why?

- acute PCL tears
- people don't do the first 3 tests

1. tibia is already sagged back
2. won't move during the test

22

posterior drawer test: What are the types of PCL tears?

- acute
- chronic

23

posterior drawer test: chronic PCL tears

- secondary restraints (capsule) become loose
- even though the tibia is already sagged back, you will feel more give as you push back on the joint