anterior cruciate ligament injury
Introduction
Introduction to Anterior Cruciate Ligament Anterior cruciate ligament injury (injuryofanteriorcruciateligamentofknee) is more common than PCL injury, and Fetto and Marshail (1980) reported that 223 of 223 lesions were combined injuries. 38% (75 cases) were simple ACL injuries, and ACL injuries often occurred in knee MCL and joint capsules. The ACL is higher in the body lesion than in the femoral condyle attachment point and in the tibia attachment point. The tibia attachment point injury sometimes appears as avulsion fracture. Kennedy (1974) counts 50 cases, and the middle part of the ligament is the most common, accounting for 36 cases. (72%), but only 9 cases (18%) of femoral condyle attachment injury, 2 cases (4%) of tibial attachment point injury, 3 cases (6%) of unknown tibial attachment, the author has reconstructed old ACL under arthroscopy in the past two years. More than 30 cases of injury, except for one case of avulsion fracture of the humerus, were ligament parenchymal fractures. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture
Cause
Cause of anterior cruciate ligament injury
Cause (25%):
When the knee joint is overstretched or strongly abducted, it can cause anterior cruciate ligament injury. ACL fracture is mostly the result of strong over-extension or strong abduction injury of the knee joint. In the case of non-loading, the over-extension can cause simple ACL injury, and knee joint flexion can also cause ACL injury.
Prevention
Anterior cruciate ligament injury prevention
The prevention of this disease is mainly to prevent complications. The treatment should pay attention to the timely restoration of the anatomical structure that maintains the joint stability, and maximize the recovery of the anatomical integrity and functional integrity of the joint, thereby avoiding or reducing the long-term complications. Occurs to better restore and maintain the function of the knee joint.
Complication
Anterior cruciate ligament injury complications Complications
A small number of patients may have intra-articular fractures or avulsion fractures.
Symptom
Symptoms of anterior cruciate ligament injury Common symptoms Joint swelling, weakness, joint pain, joint capsule injury
In the case of strong trauma, some patients feel the tearing of the knee joint, then the knee joint is weak, the joint pain is severe, the swelling is rapid, the blood in the joint, the subcutaneous ecchymosis around the joint often indicates joint capsule damage, joint dysfunction, In patients with old injuries, there may be atrophy of the quadriceps muscles, a feeling of walking or a sense of movement, and a decrease in exercise capacity. The body may be positive for the front drawer test (ADT), positive for the Lachman test, and positive for the axial shift test.
Examine
Examination of anterior cruciate ligament injury
1. Lachman test: The patient is supine, knees 15 ° ~ 20 °, the foot is placed on the bed, the examiner grasps the lower end of the patient's femur with one hand, and grasps the upper end of the humerus with one hand to push the front and rear of the opposite direction, if there is more than the healthy side Before moving, it should be regarded as positive, but it must be noted whether the difference is pulled back from the post-sink position, or it is indeed forward. This test originally intended to detect the forward movement to clear the ACL, especially to judge the ACL. Bundle or after the outer bundle damage.
2. Knee X-ray examination: It can show the humeral intercondylar torsion fracture. When the internal and external valgus stress is examined, the joint space of one side can be widened and the Segond fracture can be seen occasionally.
3. MRI: The diagnosis rate of MRI in acute phase can reach more than 5%. Because of the clear signs in the chronic phase, MRI is not necessary.
4. Knee arthroscopy.
Diagnosis
Diagnosis of anterior cruciate ligament injury
The disease belongs to ligament contusion or fracture, which can cause joint movement disorder and joint pain and swelling. It is usually necessary to differentiate from joint fractures. A plain film examination of the bone and joint can be performed if conditions permit, to determine if there is a fracture, and the severity of the fracture. Patients with fractures are often accompanied by severe pain in the joints and abnormal activities.
