ligament injury
Introduction
Introduction to ligament injury Ligament damage is the damage caused by the ligaments of a certain part of the body being damaged to varying degrees. Part of the injury is called bruise. When it is completely broken, it can avoid the bone of its attachment site, and even cause subluxation or total dislocation. When a non-physiological movement of a certain orientation occurs, the ligament that restricts the movement of the knee joint to the orientation must bear the brunt. When the knee joint is externally rotated in the flexion position and is exposed to violence from the outside, the medial joint capsule ligament and medial collateral ligament are mainly damaged. The severe fashion may involve the anterior cruciate ligament and the medial meniscus. This is the most common injury. the way. The clinical manifestations are local swelling, tenderness, or joint instability, and the pain is exacerbated when pulled in the direction of violence. Improper treatment may result in unstable or traumatic arthritis. The principles of treatment are precise diagnosis, early treatment, and comprehensive repair. Some of the injuries can be directly repaired, and severe cases need to be transferred and repaired with adjacent tendons and tendons. basic knowledge The proportion of illness: 0.05%, more common in athletes Susceptible people: no special people Mode of infection: non-infectious Complications: fracture meniscus injury
Cause
Causes of ligament injury
Strenuous exercise (30%):
In strenuous exercise, such as college sports competitions, dance, acrobatics, etc., ligament damage is easy to occur, but even in daily life, accidents such as car accidents and high altitude fall will cause similar damage.
External force factor (35%):
When a non-physiological movement of a certain orientation occurs, the ligament that restricts the movement of the knee joint to the orientation must bear the brunt. When the knee joint is externally rotated in the flexion position and is exposed to violence from the outside, the medial joint capsule ligament and medial collateral ligament are mainly damaged. The severe fashion may involve the anterior cruciate ligament and the medial meniscus. This is the most common injury. the way. The knee joint is in the straight, adducted, and internal rotation position. When the violence from the anterior side causes overextension, the external structure and the posterior cruciate ligament are often injured. In severe cases, the common peroneal nerve injury may be caused, sometimes with a fracture of the humerus. When the knee is suddenly subjected to violence and moved backwards or forwards, it may cause a fracture of the posterior cruciate ligament or anterior cruciate ligament and medial collateral ligament. Knee joint ligament injuries are common in football, basketball, skaters, and porters.
Prevention
Ligament injury prevention
Prevention plan:
Taking knee joint ligament injury as an example, sports enthusiasts or athletes are susceptible to this disease. Proper landing skills are important to prevent knee damage. It is recommended that when the athletes land, the forefoot should first land, the knees bend, and the torso leans forward slightly. Avoid lateral or frontal movements of the knee as much as possible. Remember that the knee joint should not be twisted inward when landing, and the impact force should be minimized.
The following points should be done in daily life:
First, do warm-up activities before the exercise, so that the joints heat up first.
Second, do not exercise under fatigue, so the reaction is slow, and the movement is not easy to coordinate.
Third, strengthen the exercises of lower limb strength to ensure the stability and flexibility of the knee joint.
Fourth, in sports, it is necessary to prevent accidental damage caused by rough movements.
Fifth, pay attention to the warmth of the knee joint, and the hot compress and massage of the knee joint can be performed regularly every day.
Sixth, avoid excessive fatigue of the knee joint, try not to do the knee joint squat exercise.
Seventh, those who are too obese should lose weight.
Eighth, avoid overload when exercising.
Complication
Ligament injury complications Complications, fracture, meniscus injury
Taking knee joint ligament injury as an example, the knee joint has complex structure and many traumas. The damage is mostly combined injury, especially the complication of the radial collateral ligament injury is more than 73%. Among them, the grade III injury combined with other structural damage. About 100%. Common injuries include anterior cruciate ligament injury, posterior cruciate ligament injury, meniscus injury, bone contusion, fracture, joint effusion, and soft tissue blood stasis around the knee joint. Patients with lateral collateral ligament injury may damage the common peroneal nerve and have a sagging of the foot.
Symptom
Ligament injury symptoms Common symptoms Ligament strain ligament sprain joint swelling fascia pain Elbow severe pain, ... ligament rupture
After ligament injury, there are generally small blood vessels ruptured and hemorrhage, local pain, swelling, intra-tissue hemorrhage, hematoma, joint swelling, movement disorder, tenderness. The physical examination revealed that the traction ligament was significantly painful, and if it was completely broken, the joint stability decreased.
Examine
Ligament injury examination
X-ray examination
Note the avulsion fracture caused by ligament traction and pay attention to the presence or absence of tibial plateau fracture. Stress X-ray examination is valuable for the diagnosis of ligament injury and instability. For example, if the knee joint is in the inversion or valgus stress, the corresponding internal or external gap changes.
2. Magnetic resonance
Pay attention to the structural integrity of the layers, especially the anomaly signals.
3. Arthroscopy
It is helpful to observe the cruciate ligament, meniscus injury, deep collateral ligament and joint capsule ligament injury, osteochondral fracture.
4. Special inspection
(1) Side pressure test (separation test)
The knee joint is straight, the examiner holds the injured limb in one hand, and the large fish in the other palm rests on the inner side or the outer side of the lap, and strongly adducts or abducts the lower leg, such as partial damage of the medial collateral ligament, and the cause of abduction The ligaments involved in the injury cause pain; if completely broken, there is abnormal abduction activity. Conversely, if the lateral collateral ligament is partially damaged, the ligament involved in the injury will cause pain during adduction; if it is completely broken, there will be abnormal adduction activity.
(2) Drawer test
An increase in advancement indicates rupture or relaxation of the anterior cruciate ligament, and an increase in posterior ligament indicates fracture or relaxation of the posterior cruciate ligament It should be compared with the opposite side.
(3) Axial shift test
A positive result indicates a fracture of the anterior cruciate ligament.
(4) Rotation test
Passive internal rotation and external rotation at 90° in both knees, and then examination at 45° and 0°, and differences with the contralateral side suggesting medial collateral ligament, anterior and posterior cruciate ligament injury, may have rotational instability.
Diagnosis
Ligament injury diagnosis
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
1. Meniscus injury, which is characterized by local pain in joint space, accompanied by joint interlocking phenomenon, joint bounce, tibia grinding test, and Mai's squeeze gyro test are positive.
2. Differential diagnosis of diseases such as humeral protrusion, synovitis and osteoarthritis.
