(1,3) Knee Injuries Flashcards
(60 cards)
What timeframe do the Ottawa Knee Rules apply?
knee inj <7 days old
If there are no positive criteria on Ottawa Knee Rules, what is the chance of a significant fracture?
<1%
What are the Ottawa knee rules?
“OR” rules (any of the following):
- age >55yrs
- fib head tenderness
- isolated tenderness of patella
- inability to flex 90 deg (AROM)
- inability to bear weight for 4 steps post-inj AND in clinic (regardless of limping)
What is a bumper/fender fracture?
depressed tibial plateau fx (80% lateral plateau)
What is the mechanism of a bumper/fender fracture?
valgus force (fem condyle driven into tibial plateau)
What radiographic finding will be present for a bumper/fender fracture?
FBI sign (liphemarthrosis)
What population commonly experiences bumper/fender fractures?
over 50yrs (osteoporosis)
What is a segond fracture?
avulsion of anterolateral lig, usually w/ avulsion of ITB insertion (Girdy’s tubercle), on lateral aspect of lateral tibial plateau
What is the mechanism of a Segond fracture?
pivot-shift
What soft tissues may be associated with a Segond fracture?
- ACL tear (90%)
- meniscal tear (70%)
- ITB
(LCL typically intact)
What is your next step if you suspect a Segond fracture?
MRI for soft tissue injuries
What is the mechanism of a patellar fracture?
direct or indirect trauma
What are the 4 types of patellar fractures?
- transverse
- stellate
- vertical
- osteochondral
What is the most common type of patellar fracture?
transverse
What is the clinical presentation of a patellar fracture?
- patellar tenderness
- quadriceps weakness
What type of patellar fracture occurs secondary to a dislocation?
osteochondral fx
What 2 types of patellar fractures require a sunrise view to visualize on a radiograph?
vertical
osteochondral
What is the most common direction of patellar dislocation?
lateral
What is the mechanism of a patellar fracture?
pivot-shift
What should you look for if you are suspect patellar dislocation?
osteochondral fx
What kissing contusions may be present due to lateral patellar dislocation?
- medial facet of patella
- lateral femoral condyle
(requires sunrise view)
What is the clinical significance of a femorotibial dislocation
- severe, life-threatening
- injuries of popliteal a & common peroneal n are common
What directions may a femorotibial dislocation occur in?
anterior or posterior
What soft tissue structures may be affected by a femorotibial dislocation?
all intra & extra capsular ligamentous structures usually ruptured
