Lower limb soft tissue injury Flashcards
(53 cards)
What are Achilles tendon disorders?
Achilles tendon disorders are the most common cause of posterior heel pain. Possible presentations include tendinopathy (tendinitis), partial tear, and complete rupture of the Achilles tendon.
What are the risk factors for Achilles tendon disorders?
Risk factors include quinolone use (e.g. ciprofloxacin) and hypercholesterolaemia, which predisposes to tendon xanthomata.
What are the features of Achilles tendinopathy (tendinitis)?
Features include gradual onset of posterior heel pain that worsens following activity, and common morning pain and stiffness.
What is the management for Achilles tendinopathy?
Management is typically supportive, including simple analgesia, reduction in precipitating activities, and calf muscle eccentric exercises.
What symptoms suggest an Achilles tendon rupture?
Symptoms include an audible ‘pop’ in the ankle, sudden onset significant pain in the calf or ankle, and inability to walk or continue the sport.
What is Simmond’s triad used for?
Simmond’s triad is used to help exclude Achilles tendon rupture by examining the angle of declination, feeling for a gap in the tendon, and assessing calf muscle response.
What is the initial imaging modality of choice for suspected Achilles tendon rupture?
Ultrasound is the initial imaging modality of choice for suspected Achilles tendon rupture.
What should be done following a suspected Achilles tendon rupture?
An acute referral should be made to an orthopaedic specialist following a suspected rupture.
What are the bony components of the ankle joint?
The bony components include the distal tibia, fibula, and the superior aspect of the talus.
What is the configuration of the ankle joint?
The configuration forms a mortise, with the body of the talus acting as the tenon.
What ligaments secure the distal tibia and fibula together?
The syndesmosis binds them together, composed of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), interosseous ligament (IOL), and the interosseous membrane.
What ligaments secure the distal fibula to the talus and calcaneus?
The anterior and posterior talofibular ligaments (ATFL and PTFL) secure the distal fibula to the talus, and the calcaneofibular ligament secures it to the calcaneus.
What ligament secures the distal tibia to the talus?
The deltoid ligament secures the distal tibia to the talus.
What is a sprain?
A sprain is a stretching, partial, or complete tear of a ligament.
What are the two types of ankle sprains?
High ankle sprains involving the syndesmosis and low ankle sprains involving the lateral collateral ligaments.
What is the most common type of ankle sprain?
Low ankle sprains are the most common, accounting for over 90% of cases.
What is the most common mechanism of low ankle sprains?
The most common mechanism is an inversion injury.
What are the classifications of low ankle sprains?
They are classified into Grade I (mild), Grade II (moderate), and Grade III (severe).
What is the treatment protocol for low ankle sprains?
The treatment includes rest, ice, compression, and elevation (RICE protocol).
What should be done if symptoms of a low ankle sprain fail to settle?
An MRI and surgical intervention may be contemplated if symptoms fail to settle or there is significant joint instability.
What is the presentation of high ankle sprains?
High ankle sprains are rare (about 0.5%) and often involve severe pain when weight-bearing.
What is the mechanism of injury for high ankle sprains?
The mechanism is usually external rotation of the foot, causing the talus to push the fibula laterally.
What test is used to assess high ankle sprains?
The Hopkin’s squeeze test assesses pain when the tibia and fibula are squeezed together at the mid-calf.
What should be done if there is diastasis in a high ankle sprain?
Operative fixation is usually warranted if diastasis or failed non-operative management occurs.
