0071643192.pdf

ORTHOPEDICS

COMPLICATIONS

If resulting from lateral blow to knee is often associated with medial collateral

ligament tear and lateral meniscus injury (terrible triad)

POSTERIORCRUCIATELIGAMENT(PCL) INJURY

Far less common than ACL tears and usually occurs in combination with

other injuries

DIAGNOSIS

Positive posterior drawer test is suggestive. MRI or arthroscopy is diagnostic.

TREATMENT

Rest, ice, elevate, NSAIDs, immobilization, orthopedics referral, physical therapy

MEDIALCOLLATERALLIGAMENT(MCL)AND

LATERALCOLLATERALLIGAMENT(LCL) INJURIES

DIAGNOSIS

Positive varus (medial) stress test for LCL injury or valgus (lateral) stress test

for MCL injury are suggestive. MRI or arthroscopy is diagnostic.

TABLE 4.3. Physical Examination of the Knee

TEST MANEUVER ABNORMALITY

Valgus stress Instability with valgus stress in 30° flexion Tear of the MCL

Varus stress Instability with varus stress in 30° of flexion Tear of the LCL

Anterior drawer Instability with anterior stress with knee Tear of the ACL

sign in 90° of flexion

Lachman’s test Instability with anterior stress in 15—30° of Tear of the ACL

flexion; more sensitive than drawer signs

Posterior drawer Instability with posterior stress in 90° Tear of the PCL

sign of flexion

McMurray’s Pain as the knee is brought from full Medial joint line pain =

test flexion to 90° flexion while the leg is medial meniscus injury.

externally rotated with compression Lateral joint pain =

over the medial joint line and/orwhen lateral meniscus injury.

the leg is internally rotated with

compression over the lateral joint line

Ege’s test In squatting position, pain, and/or External rotation =

click on maximum rotation of knee medial meniscus tear.

Internal rotation =

lateral meniscus tear.