Orthopedics Lower Extremity Part 1
1. Ottawa Knee rules xray when one criterion is met: patient age > 55 years
tenderness at head of fibula
isolated tenderness of patella
inability to flex knee to 90 degrees
inability to transfer weight for four steps both immediately after the injury and in the ED
2. what type of fracture if highly suggestive of ACL tear: segond fracture (evulsion fracture
off of tibial head)
3. gold standard treatment for ACL tear: ACL reconstruction
4. special tests for PCL tear: posterior sag sign
dial test - (PCL 90)
reverse pivot shift testing
posterior drawer
5. treatment of PCL tear: isolated can be treated non-surgical - rehab
surgery if unstable
6. MCL injury occurs from: valgus force or rotational injury
1/6
, 7. LCL injury occurs from: varus force
8. special tests for MCL and LCL injuries: valgus stress test
varus stresss test
dial test for LCL injuries
9. if there is an effusion on xray with MCL or LCL injury suspect: meniscus/cruciate injury
patella dislocaiton
10. MCL injury treatment: majority non operative: hinged knee brace
11. LCL injury treatment: operative more common
12. meniscus injury can be due to: axial lode with rotation
13. acute mensiscus tears more common in: younger pts
14. what type of meniscus injury is more common: medial more common than lateral
15. special tests for meniscus injury: McMurray test
Apley test
2/6
1. Ottawa Knee rules xray when one criterion is met: patient age > 55 years
tenderness at head of fibula
isolated tenderness of patella
inability to flex knee to 90 degrees
inability to transfer weight for four steps both immediately after the injury and in the ED
2. what type of fracture if highly suggestive of ACL tear: segond fracture (evulsion fracture
off of tibial head)
3. gold standard treatment for ACL tear: ACL reconstruction
4. special tests for PCL tear: posterior sag sign
dial test - (PCL 90)
reverse pivot shift testing
posterior drawer
5. treatment of PCL tear: isolated can be treated non-surgical - rehab
surgery if unstable
6. MCL injury occurs from: valgus force or rotational injury
1/6
, 7. LCL injury occurs from: varus force
8. special tests for MCL and LCL injuries: valgus stress test
varus stresss test
dial test for LCL injuries
9. if there is an effusion on xray with MCL or LCL injury suspect: meniscus/cruciate injury
patella dislocaiton
10. MCL injury treatment: majority non operative: hinged knee brace
11. LCL injury treatment: operative more common
12. meniscus injury can be due to: axial lode with rotation
13. acute mensiscus tears more common in: younger pts
14. what type of meniscus injury is more common: medial more common than lateral
15. special tests for meniscus injury: McMurray test
Apley test
2/6
