Knieverstauchungen And Meniscus Injuries

Sprains the external (ligaments. Collaterale medial and lateral) or internal (ligaments. Cruciatum anterior and posterior) tape or meniscus injury can result from a knee trauma. Symptoms include pain, joint effusion, instability (in severe sprains) and blocking (for some meniscus injuries). The diagnosis is made by clinical examination and sometimes by MRI. The treatment involves gypsum plant or surgical intervention PRICE (protection, rest, ice, compression, elevation), and in more severe cases.

Some structures that stabilize the knee, are mainly outside the joint. These include muscles (eg. As the quadriceps, hamstrings), their approaches, for. B. pes and extracapsular ligaments. The lateral collateral ligament is extracapsular; the medial (tibial) has a superficial portion and an extracapsular located in-depth portion, which is part of the joint capsule.

Sprains the external (ligaments. Collaterale medial and lateral) or internal (ligaments. Cruciatum anterior and posterior) tape or meniscus injury can result from a knee trauma. Symptoms include pain, joint effusion, instability (in severe sprains) and blocking (for some meniscus injuries). The diagnosis is made by clinical examination and sometimes by MRI. The treatment involves gypsum plant or surgical intervention PRICE (protection, rest, ice, compression, elevation), and in more severe cases. Some structures that stabilize the knee, are mainly outside the joint. These include muscles (eg. As the quadriceps, hamstrings), their approaches, for. B. pes and extracapsular ligaments. The lateral collateral ligament is extracapsular; the medial (tibial) has a superficial portion and an extracapsular located in-depth portion, which is part of the joint capsule. In the interior of the knee, the bands of the joint capsule and the anterior and posterior cruciate ligaments vascularized help to stabilize the joint. The medial and lateral meniscus is located intra-articular cartilage, which mainly serve for shock absorption and to a limited extent to joint stability contribute (ligaments of the knee.). Ligaments of the knee. Affected injuries most common knee structures include Medial Collateral Ligament and the anterior cruciate ligament. Mechanism predicts the type of injury: Inward (valgus) power: Normally, the medial collateral ligament, followed by anterior cruciate ligament, then then (the medial meniscus, this mechanism is the most frequent and is normally accompanied by an external rotation and bend as when is attacked in football) outward facing (varus) power: Often, the lateral collateral ligament, the anterior cruciate ligament, or both (this mechanism is the second most common) forward or backward directed force and overstretching: Typically, the cruciate ligaments the carrying a load or a rotation at the moment of trauma: increase within the first hours usually meniscus symptoms and complaints swelling and muscle spasms. In second-degree sprain, the pain is more moderate to strong. In third-degree sprain, the pain is rather light and surprisingly, patients can often still walk unaided. Some patients, hear or feel a pop when the injury occurs. This finding suggests a torn ligament anterior cruciate ligament, but is not a reliable indicator. Point of the sensitivity and pain depends on the injury: Sprained medial or lateral bands: sensitivity over the damaged tape medial meniscus injury: sensitivity in the joint plane (joint line sensitivity) medial lateral meniscus injury: sensitivity in the joint plane laterally Medial and lateral meniscus injury: Pain aggravated by extreme flexion or extension and restricted passive knee movement (locking) of a knee injury bands or menisci cause a visible and palpable joint effusion. Diagnostic stress tests X-rays to rule out fractures Sometimes MRI Diagnosis is primarily clinical. In patients with severe hemarthrosis, a strong instability of a knee or both, should be considered a spontaneous reduction of dislocation; a detailed vascular examination, including the ankle-brachial index should be done immediately (Knieluxationen (tibiofemoral)). After that, the knee is examined clinically. The active knee extension is examined in all patients with knee pain and effusion, to eliminate rupture of the extensor mechanism (z. B. rupture of the quadriceps or patellar tendon, or a fracture of the Patellasehene or Tibiatuberkels- injuries of the knee extension mechanism). Tips and risks check immediately on vascular lesions when patients have a large Kniehämarthrose, large knee instability or both. Stress tests Stress tests help to evaluate the integrity of the tapes to distinguish partial tears of complete tears. However, if patients have significant pain and swelling or muscle spasms, the investigation is delayed usually exclude fractures up radiographs. Considerable swelling and cramps can complicate an assessment of joint stability. These patients should be examined after injection of a local anesthetic or a systemic analgesia and sedation, or 2-3 days later (after cessation of swelling and cramps) during an inspection appointment. Stress tests at the bedside are performed to test for certain injuries, although most of these tests are not very accurate or reliable. Stress tests at the bedside doctors move the joint in the direction in which the tested band normally prevents excessive articulation. In the Apley test, the patient lies on his stomach and the examiner stabilizes the patient’s thigh. The doctor bends the patient’s knee at 90 ° and turns the lower leg, while pressing the leg downwardly in the direction of the knee (compression). Then he turns the lower leg as he pulls him from the knee (distraction). Pain during compression and the rotation point to a violation of the meniscus, pain during Längszugs while rotating on a violation of the ligament or joint capsule out. To assess the medial and lateral collateral ligament of the patient is in the supine position with a bent by 20 ° at the knee and thigh muscles relaxed. The doctor puts a hand on the side of the knee that is not affected. With the other hand it includes the heel and pushes the lower portion of the leg to the outside to check the medial collateral ligament, and inwardly to check the lateral collateral ligament. A slight instability after trauma suggests a participation of a meniscus or the crack of a cruciate ligament or collateral ligament. The Lachman test is suitable for the detection of acute anterior cruciate ligament. The patient lies on his back, the doctor supports the thigh and calf while. The patient’s knee at an angle of 20 ° prevented. The lower leg he bewergt forward. An excessive passive mobility of the leg forward of the femur raises the suspicion of a significant rupture nahe.Bildgebende method Not every patient needs an X-ray examination. However, anteroposterior, lateral and oblique radiographs are often used to rule out fractures. The Ottawa knee rules are used to limit X-ray examinations for patients with a fracture that requires more specific treatments. X-ray examinations should be performed when one of the following is true: age> 55 years Accrued sensitivity of the patella (without other bone sensitivity of the knee) sensitivity of the fibular inability knee to bend to 90 ° inability ankle immediately after the injury or the initial examination for 4 steps to load (with or without claudication) the use of MRI in the initial assessment is much debate. A sensible approach is to carry out an MRI when the symptoms do not resolve after several weeks of conservative treatment. However, an MRI is often performed when serious injury or significant intra-articular injuries are suspected or can not be excluded in other ways. Treatment Light sprains: protection, rest, ice, compression and elevation (PRICE method) severe injury: splinting or a toggle lock and referral to an orthopedic surgeon for surgical intervention A drainage greater effusions (. Arthrocentesis the knee) can be used for pain relief and reduction of spasms contribute. Most of first-degree and second-degree, the moderate injuries can be treated by a PRICE therapy, including immobilization of the knee in a 20 degree bend by means of a Knieimmobilisators commercially available or gypsum initially. Early motion exercises are usually supported. In severe second-degree and third-degree sprains in most gypsum treatment ? 6 weeks is required. Some third-degree injury to the medial collateral ligament, the anterior cruciate ligament arthroscopic intervention is required. Patients with severe injuries are referred to an orthopedic surgeon for surgery. Meniscus injuries are very different in their characteristics and treatments. Large, complex or vertical cracks and injuries that result in persistent effusions or disabling symptoms rather require surgery. The preference of the patient can influence the choice of therapy. Physical therapy may be helpful, depending on the patient and the type of injury. Important Points stress tests (sometimes days after the injury done) are necessary for the differentiation between partial and complete tears. Pull injuries to the anterior cruciate ligament and other intra-articular structures considered if patients have an effusion after an injury. Drag a knee dislocation and popliteal artery injuries into account when patients have a large hemarthrosis, great instability or both. If patients have knee pain and effusion, test the active knee extension in order to prevent rupture of the extensor mechanism (eg. As rupture of the quadriceps or patellar tendon, or a fracture of Patellasehene or Tibiatuberkels). Insert a MRI if the symptoms do not resolve after several weeks of conservative treatment, or if possibly serious injury or significant intra-articular injuries are suspected or can not be ruled differently.

Health Life Media Team

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