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91

What other things are commonly injured with collateral ligament injuries?

Popliteus tendon
Popliteofibular ligament
Peroneal nerve (extreme case)
Biceps femoris tendon (extreme case)

92

Can pts usually walk with collateral ligament injury?

Usually can ambulate and sometimes even return to play

93

Swelling for collateral ligaments?

Sometimes localized ecchymosis after 24-48hrs

94

PE findings with collateral ligaments?

TTP along joint line
Pain +/- instability with valgus (MCL) or varus (LCL) stress

Compare the sides

95

Swelling is often associated w collateral ligament injuries but what if its large effusion?

Often indicates associated intra-articular injury

96

tenderness in MCL injury?

Tender along entire course from:
Medial femoral condyle to broad tibial insertion
Just distal to the pes anserinus

97

Tenderness with LCL?

Tender anywhere along the course from lateral femoral epicondyle to its insertion on fibular head

98

Best position to palpate MCL?

Slight flexion

99

Best position to palpate LCL?

Figure 4 position

100

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

101

Collateral ligament grades?

Measure of joint space opening:

Grade I: <5mm: interstitial tear
Grade II: 6-9mm: partial tear
Grade III: >10: complete tear

102

Are x rays good for collateral ligaments?

Ap and lat are usually negative however:
May reveal an avulsion fx

103

When should you order an MRI?

When multilligament injury is suspected with gross laxity stress at 0 degrees

104

Why are collateral ligament injuries usually treated nonsurgically?

They are extra-articular and have good blood supply so they can heal on their own

105

Tx for isolated grade I and II collateral ligament injury?

Supportive:
-RICE
-Crutches
-NSAIDS

ROM exercises early
Hinged brace

106

Grade III MCL injury tx?

Proximal and w/in midsubstance can be treated nonsurgically w hinged brace

107

Why should long term immobilization be avoided with collateral ligaments (or anything really)?

Stiffness tends to develop

108

How long will collateral ligament injuries be in a brace?

3-4 months

109

Who gets surgery (collateral ligament)?

Isolated grade III LCL injury usually involving posterolateral capsular complex and popliteus tendon

110

How are avulsions usually treated?

Usually repaired and need to be done w/in 7 days of injury

111

What is the big concern with collateral ligaments post healing?

Recurrence of injury is common especially for first 6 months

112

What collateral ligaments get to go to ortho?

Hemarthrosis
Significant effusion
Instability
Grade III

113

What needs to be done with posterior lateral corner injuries?

Consult w/in 72hrs

114

Give 100%

110% is impossible, only idiots recommend that
- ron swanson