Chapter 15 Injuries to the Pelvis and Lower Extremities

The Pelvis Pelvic region Constitutes the inferior portion of the trunk Provides support to vertebral column Primary muscles of the pelvis Affect movement of thigh at hip joint Attached to the femur and pelvic bones Contribute to muscular movement by creating pressure on muscle surface 2

Injuries to the Pelvic Region Fractures Strains Contusions 3

The Hip and Thigh Each lower extremity consists of a: Hip, thigh, knee, lower leg, ankle, and foot The hip is a ball and socket joint. Held together by connective tissues The femur is held in the acetabulum by ligaments, tendons, and muscles. 4

The Hip and Thigh This joint allows abduction, adduction, flexion, extension, medial rotation, lateral rotation, and circumduction of the femur. The femur extends from the hip to the knee. Provides skeletal structure of the thigh 5

Assessing Hip Injuries Range-of-Motion (ROM) Evaluations General range of motion Hamstring flexibility Hip flexor flexibility (Thomas test) Internal and external rotation of the hip 6

Assessing Hip Injuries Manual Muscle Tests for the Hip Abduction strength test Adduction strength test Extension strength test Gluteals and hamstrings Quadriceps Flexion strength test Internal rotation strength test 7

Assessing Hip Injuries Manual Muscle Tests for the Hip External rotation strength test Trendelenburg test Ober’s test Patrick’s or Faber test 8

Injuries to the Hip and Thigh Osteitis Pubis Fractures Dislocations and subluxations Contusions Sprains Strains Bursitis and synovitis 9

The Knee Knee joint Naturally unstable One of the most complicated and commonly injured joints in the body Knee consists of the patella, the inferior end of the femur, the superior ends of the tibia and fibula, and several supporting ligaments and tendons 10

Assessing Knee Injuries Range-of-Motion Evaluations Knee extension Knee flexion Manual Muscle Tests for the Knee Extension strength test Flexion strength test 11

Injuries to the Knee and Lower Leg Fractures Dislocations and subluxations Apprehension test for the patella Contusions Sprains Vagus stress test Varus stress test 12

Injuries to the Knee and Lower Leg Sprains, continued Anterior draw test Posterior draw test Lachman test Pivot shift test 13

Injuries to the Knee and Lower Leg Strains Tendon ruptures Patellar tendon rupture test Tears of the meniscus McMurray test Apley compression test Tendonitis Inflammation of the Patellar Fat Padv 14

Injuries to the Knee and Lower Leg Bursitis Osgood-Schlatter disease Chondromalacia patella (CMP) Patella grind test Shin splints (medial tibial stress syndrome [MTSS]) Anterior compartment syndrome 15

The Ankle and Foot The ankle, or tarsus is composed of seven tarsal bones and joins the lower leg to the foot. The foot consists of the tarsus, metatarsus (instep), and phalanges (toes). 16

Assessing Ankle and Foot Injuries Range-of-Motion Evaluations Ankle inversion Ankle eversion Plantar flexion of the ankle Dorsiflexion of the ankle 17

Assessing Ankle and Foot Injuries Manual Muscle Tests for the Ankle/Foot Plantar flexion strength test for the ankle Dorsiflexion strength test for the ankle Inversion strength test for the ankle Eversion strength test for the ankle 18

Injuries to the Ankle and Foot Fractures Dislocations and subluxations Contusions Sprains Talar tilt test Anterior drawer test for the ankle 19

Injuries to the Ankle and Foot Tendon ruptures Thompson test Tendonitis Bursitis and synovitis Ingrown toenail Turf toe Athlete’s foot Plantar fasciitis 20