Flashcards in Lecture 4 Deck (114)
What other things are commonly injured with collateral ligament injuries?
Peroneal nerve (extreme case)
Biceps femoris tendon (extreme case)
Can pts usually walk with collateral ligament injury?
Usually can ambulate and sometimes even return to play
Swelling for collateral ligaments?
Sometimes localized ecchymosis after 24-48hrs
PE findings with collateral ligaments?
TTP along joint line
Pain +/- instability with valgus (MCL) or varus (LCL) stress
Compare the sides
Swelling is often associated w collateral ligament injuries but what if its large effusion?
Often indicates associated intra-articular injury
tenderness in MCL injury?
Tender along entire course from:
Medial femoral condyle to broad tibial insertion
Just distal to the pes anserinus
Tenderness with LCL?
Tender anywhere along the course from lateral femoral epicondyle to its insertion on fibular head
Best position to palpate MCL?
Best position to palpate LCL?
Figure 4 position
Laxity in full extension for collateral ligaments indicates?
More extensive injury to the anterior and posterior crucial ligaments plus posterior capsule rather than to just the MCL or LCL
Collateral ligament grades?
Measure of joint space opening:
Grade I: <5mm: interstitial tear
Grade II: 6-9mm: partial tear
Grade III: >10: complete tear
Are x rays good for collateral ligaments?
Ap and lat are usually negative however:
May reveal an avulsion fx
When should you order an MRI?
When multilligament injury is suspected with gross laxity stress at 0 degrees
Why are collateral ligament injuries usually treated nonsurgically?
They are extra-articular and have good blood supply so they can heal on their own
Tx for isolated grade I and II collateral ligament injury?
ROM exercises early
Grade III MCL injury tx?
Proximal and w/in midsubstance can be treated nonsurgically w hinged brace
Why should long term immobilization be avoided with collateral ligaments (or anything really)?
Stiffness tends to develop
How long will collateral ligament injuries be in a brace?
Who gets surgery (collateral ligament)?
Isolated grade III LCL injury usually involving posterolateral capsular complex and popliteus tendon
How are avulsions usually treated?
Usually repaired and need to be done w/in 7 days of injury
What is the big concern with collateral ligaments post healing?
Recurrence of injury is common especially for first 6 months
What collateral ligaments get to go to ortho?
What needs to be done with posterior lateral corner injuries?
Consult w/in 72hrs