Flashcards in Lecture 4 Deck (114)
Claw vs hammer vs mallet
Claw: MTP extension
Hammer: PIP flexion
Mallet: DIP flexion
Important HX questions for knee injuries?
Onset of pain
Location of pain
Injury-associated events (catching/locking, pop etc)
What are the degrees of immediate dysfunction
Unable to ambulate
Continued to participate (sports)
Knee anterior structures
Posterior knee structures
Medial knee structures?
Lateral knee structures?
posterior lateral corner of knee injury involves what structures?
Lateral collateral ligament
Prolonged sitting causes patella pain.
Knee is in relaxed flexed position, the patella will ride on one side of the knee and it will cause pain.
Noncontact injury with “pop” is probably?
Contact injury with “pop” is probably?
MCL, LCL tear
Acute effusion (<12hrs) is probably?
Lateral blow to the knee is probably?
Medial blow to the knee is probably?
Knee “gave out” or “buckled” is probably?
Fall onto flexed knee is probably?
Joint injuries and their likelihood of hemarthrosis?
Patellar dislocation: 11-20%
W/ osteochondral lesion: 5%
Genu varum vs genu valgum?
Varum: knees out
Valgum: knees in (gum)
Diagnostic studies you should get on pts with genu varum and ganu valgum?
Leg length radiographs and hip radiographs
The deformity may be in the hip or legs not the knee
ASIS-patella and the plane of the tibial tuberosity (hip form affects the femoral to tibial angle)
What is normal Q angle?
Special tests for knee?
Apley compression test
Anterior drawer test
Lateral pivot shift test
Slide 19 has pics
Patellofemoral stability test?
Slide patella back and forth
- patellar slide: 25-50%
- patellar tilt: 15*
Just compare the knees to look for difference
What MOI causes patellar dislocation?
Rotation over planted foot (softball swing)
Sudden cutting movement
What radiography should be ordered for knees, why?
x ray: because its everything
MRI: r/o associated injuries
Valgus stress test?
Pull ankle laterally and push knee medically, look for laxity in MCL
at 0* no laxity
At 30* some laxity
MCL tears and rupture prognosis?
Proximal ruptures: heal quickly but are stiff
Complete ruptures: can displace joint
Entire ligament: persistent laxity after non-operative tx
Varus stress test?
Pulling ankle medial and pushing knee lateral
Stablize thigh and pull leg toward you (w 30* flexion) and laxity = badness