04 MCL Flashcards Preview

7212 Pathophysiology > 04 MCL > Flashcards

Flashcards in 04 MCL Deck (37):
1

MCL sprains: MOI

- traumatic valgus force
- twisting injury associated with an ACL injury

2

MCL sprains: clusters of s/s (symptoms)

- patient describes MOI
- may describe a "tearing" sensation
- pain
- pain with palpation over MCL

3

Where on the MCL will there be pain for a sprain?

- most common at joint line
- 2˚ at proximal attachment

4

MCL sprains: clusters of s/s (signs)

- localized swelling (extra-articular)
- effusion (if injury also affects the meniscus or ACL)
- increased c/o pain with valgus stress testing
- laxity testing

5

severity of sprains and laxity testing

depends on severity whether there's instability

6

sprain

involves noncontractile tissue

7

strain

involves contractile tissue

8

primary medial restraint for the knee

MCL

9

primary lateral restraint for the knee

LCL

10

medial restraints: %
MCL at 0˚

57%

11

medial restraints: %
MCL at 30˚

78%

12

lateral restraints: %
LCL at 0˚

55%

13

lateral restraints: %
LCL at 30˚

69%

14

What is the significance of the percentages of lateral and medial restraints of the knee?

it's the scientific reasoning (evidence) of why you test the knee at 0˚ and 30˚

15

grade I sprain

- mild sprain
- interstitial injury to MCL
- pain, but no laxity on valgus stress testing

16

grade II sprain

- moderate sprain
- partial tear of MCL

17

subdivisions of a grade II sprain

1+
2+

18

grade II 1+ sprain

1-5 mm more laxity than uninvolved side

19

grade II 2+ sprain

6-10 mm more laxity than uninvolved side

20

grade III sprain

- severe sprain
- total rupture

21

subdivision of a grade III sprain

3+

22

grade III 3+ sprain

≥10 mm more laxity than uninvolved side

23

MCL valgus stress testing: closing the joint

- first move toward varus to approximate the femur to the tibia
- done so you can palpate the joint line and kinesthetically feel the amount of motion

24

MCL valgus stress testing: what should you consider if it's a younger person?

- Think femoral epiphyseal plate injury
- ligament is stronger than the physes in younger patients

25

What is also possible with an MCL valgus stress injury? (PF)

PF subluxation is a potential additional injury and comorbidity

26

What treatments are common to all grades of MCL sprains?

- treat the symptoms
- MCL double upright brace
- dynamic stability exercises
- neuromuscular reactive training exercises
- functional (specificity) exercises

27

In addition to the treatments done for all sprains, what must be avoided with Grades II and III sprains in particular?

avoid valgus stresses in rehab

28

For a Grade III MCL sprain, what must be used immediately post injury?

drop lock brace

29

Drop lock brace for grade III sprain

Week 1: (0˚) 30-90˚
Week 2: 20-100˚
Week 3: 10-110˚
Week 4: 0-120˚

30

Grade I MCL sprain: return to activity

- back to sports 1-3 weeks
- avg 2 weeks
- with MCL double upright brace

31

Grade II MCL sprain: return to activity

- back to sports in 3-5 weeks
- avg 4 weeks
- with MCL double upright

32

Grade II 1+ return to sports

3 weeks

33

Grade II 2+ return to sports

4-5 weeks

34

Grade III MCL sprain: return to activity

- back to sports 9-12 weeks
- avg 8-10 weeks
- with MCL double upright brace

35

MCL surgical repair

very few GIII MCL sprains have a primary repair

36

When would a MCL primary repair be indicated?

- only for high performance patient with functional instability
- multiple plane injuries

37

When must a primary MCL repair occur if it's indicated?

within the first several days following injury