文档介绍：ASSESSMENT AND MANAGEMENT OF THE KNEE AND LOWER LIMB
Overview
History
Examination
X-rays
Fractures and Dislocations.
Soft Tissue Injuries
Other Knee/Lower limb Problems
Anatomy of the Knee
Meniscus
Quads insertion
Ligamentum patellae
Patella
Femur
Tibia
Medial Collateral Ligt
Fibula
ACL
PCL
HISTORY
Mechanism of injury is vitally important.
Flexed/Twisting
Forced flexion/Hyperextension
Falls/Direct Blow
Swelling Rapid/Gradual
Previous Knee Problems
No Injury or Previous Problems?
KNEE EXAMINATION
Look
Wasting,swelling,deformity
,redness,scars
Feel
Temp,Effusion,crepitus
Move
Passive,Active
Resting position,SLR,Extension,flexion,collateral ligaments, cruciates menisci
X-RAYS
Ottawa Knee Rules
Xrays are only required if the following are present.
Isolated bony tenderness of the patella.
Bony tenderness of the fibula head.
Patient cannot flex knee to 90°
Patient cannot weight bear (4 steps) after injury or in A&E
Exceptions
Knee
Tibia Plateau fracture
Fall extended pression # proximal tibia.
Valgus stress, # lateral tibia plateau
Varus stress, # medial tibia plateau
Proximal tibia examination reveals tenderness.
Swelling, haemarthrosis, ligament damage.
X-ray
Fracture of lateral tibial plateau