1. Chapter 15 Injuries to the Thigh, Leg, and Knee

2. Anatomy Review Bones of the Region 1. 2. 3. 4.

3. Musculature Muscles of the Region

4. Ligaments Knee Ligaments Major ligaments are: Tibial or medial collateral. Fibular or lateral collateral. Medial and lateral collaterals protect the knee from _______/_________ forces.

5. Meniscus There are two semicircular fibrocartilaginous disks in the knee known as the __________. These disks are located in the space between the __________________________. Responsible for lubrication and nourishment of the knee joint, weight distribution, and assistance with _______________________.

6. Common Sports Injuries Fractures of the Femur and/or Patella These injuries may also be in the form of a stress fracture, especially in the femoral neck region.

7. Fractures of the Femur and/or Patella In the adolescent, femoral fractures may include slipped capital epiphysis injuries. In the adult, fractures of the femoral neck may result in ______________________of the femoral head.

8. Fractures of the Femur and/or Patella (cont.) Signs and symptoms include: The injury needs to be evaluated by a physician. Avascular necrosis is a serious complication.

9. Fractures of the Femur and/or Patella (cont.) First Aid Treat for shock. Apply sterile dressings to any open wounds. Arrange for transport to a nearby medical facility. Courtesy of Kevin G. Shea, MD, Intermountain Orthopaedics, Boise, Idaho

10. Dislocation of the Knee or Tibiofemoral Joint Dislocation of the knee or the tibiofemoral joint can compromise blood flow to the lower leg. Signs and symptoms include: First Aid

11. Soft Tissue Injuries to the Thigh These injuries usually result from direct contact with an opponent or self-inflicted muscle strain. Signs and symptoms of a muscle contusion include:

12. Muscular Strains to the Thigh Hamstrings and adductor muscles are most likely to sustain strains. Hamstrings usually are weaker and more susceptible to strains than quadriceps. Stretching is a part of recovery program.

13. Muscular Strains to the Thigh (cont.) Signs and symptoms include :

14. Muscular Strains to the Thigh (cont.) First Aid

15. Patellofemoral Joint Injuries Acute and chronic injuries can affect patellofemoral joint. Such injuries can be debilitating and must be treated. _________________________________or “joint mice” Condition occurs when small pieces of bone are dislodged from joint and float within capsule. Damage to joint surface can occur.

16. Patellofemoral Joint Injuries (cont.) Signs and symptoms of OCD include: First Aid

17. Bursae of the Knee A bursa is a small fluid-filled sac located at strategic points.

18. Bursae of the Knee (cont.) Inflammation can be caused by: The prepatellar bursa is susceptible to direct trauma.

19. Bursae of the Knee (cont.) Signs and symptoms include : Courtesy of Brent Mangus

20. Bursa of the Knee (cont.) First Aid

21. Patellar Dislocation/Subluxation Instead of moving normally, the patella moves laterally and may dislocate.

22. Patellar Dislocation/Subluxation (Cont.) Signs and symptoms include:

23. Patellar Dislocation/Subluxation (cont.) First Aid

24. Osgood-Schlatter Disease and Jumper’s Knee Osgood-Schlatter and _______________ usually involve irritation of the patellar tendon complex. Signs and symptoms of Osgood-Schlatter include:

25. Osgood-Schlatter Disease First Aid

26. Jumper’s Knee Signs and symptoms of jumper’s knee include: First Aid

27. Patellofemoral Conditions Some conditions of the patella may be related to the ________________. The Q angle is the difference between a straight line drawn from the anterior superior iliac spine and the center of the patella and a line drawn from the center of the patella through the center of the tibial tuberosity.

28. Patellofemoral Conditions (cont’d) An excessive Q angle may be related to problems such as patellar _________________.

29. Meniscus Injuries Menisci are typically damaged by quick, sharp, cutting movements. There are many different types of tears, and they affect each athlete differently.

30. Meniscus Injuries (cont.) Signs and symptoms include:

31. Meniscus Injuries (cont.) First Aid

32. Knee Ligament Injuries Injury may occur to the MCL, LCL, ACL, or PCL. © Alessandro Bianchi/Reuters/Landov

33. Knee Ligament Injuries (cont.) Sprain to MCL is a common sports injury. Both types of sprains render knee unstable in side-to-side movements.

34. Knee Ligament Injuries (cont.) Cruciate Ligament Injuries ACL can be injured when the tibia moves forcefully in an anterior direction or when the femur gets pushed backward while the tibia is held in place. The stronger the quadriceps activation during eccentric contraction, the greater the likelihood of ACL injury, especially in female athletes.

35. Cruciate Ligament Injuries Signs and symptoms include:

36. Cruciate Ligament Injuries (cont.) First Aid

37. Prevention Research is continuing to outline techniques that will hopefully prevent various injuries. Protective bracing should be the athlete’s choice.

38. Knee Bracing ___________ ______ The general consensus regarding prophylactic knee braces indicates that they do not prevent knee ligament injuries. Courtesy of DJO Incorporated Courtesy of Mueller Sports Medicine

39. Knee Bracing (cont.) ________________________ These braces tend to work better than prophylactic braces for assisting athletes after reconstructive knee surgery. Monitor athletes to make sure they wear braces during participation. Courtesy of Bledsoe Brace Systems