It's all about injuries of the lower limb. injuries include patellar fracture, bumper fracture, foot drop and dislocation of hip joints, intertrochanteric fracture and sciatic nerve and common peroneal nerve injury....

1. INJURIES OF THE
LOWER LIMB

2. ▣ Femur can be fractured at the following points
◼ Femoral head
◼ Neck
◼ Intertrochanteric region
◼ Shaft
Fractures of the Femur

4. ▣ Distal (Further away from hip) fractured
fragment is pulled up by the muscles
that are attached to it, leading to
shortening of the limb. It may also get
rotated internally or externally.

5. ▣ Results in shortened lower limb with Internal
Rotation
Fracture of the Femoral
Head

6. ▣ Ischemic Necrosis of Head and Neck of femur due to
injury to Medial Femoral Circumflex Artery.
▣ Results in shortened lower limb with External
Rotation
Fracture of the Neck of Femur

8. Intertrochanteric Fracture
▣ Fracture along the
intertrochanteric line between
the greater and lesser
trochanters
▣ Results in shortened lower
limb with External Rotation

9. Fracture of Shaft of Femur
▣ Results in shortening of lower limb and External
rotation

10. ▣ Fracture of the distal shaft of the femur may also result
in injury to the popliteal artery.

11. Transverse patellar fracture
▣ The Proximal fragment of the patella is pulled superiorly
with the quadriceps tendon
▣ The distal fragment remains with the patellar ligament

12. Bumper fracture
▣ Fracture of the lateral Tibial
condyle that is caused by an
automobile bumper
▣ Associated with a common
peroneal nerve injury

13. Fracture of the fibular neck
▣ Leads to injury to the Common
Peroneal Nerve as it moves laterally
around the neck of the fibula
▣ Results in injury to all the muscles in
the anterior and lateral compartment of
the leg
▣ Causes Foot drop

15. ▣ Femoral head pops out of acetabulum
▣ Bulge may be noticeable at
femoral heads new location
▣ Dislocation may be:
◼ Posterior
◼ Anterior
Dislocation of Hip Joint

16. ▣ Accounts for 90% of hip dislocations
▣ Affected lower limb will be
◼ Shortened
◼ Flexed
◼ Adducted
◼ Medially rotated
Posterior dislocation of
the hip joint

17. ▣ Affected limb will be:
◼ Slightly flexed
◼ Abducted
◼ Laterally rotated
Anterior dislocation of
the hip joint

19. Drawer sign
▣ This is a test with checks for the integrity of the cruciate
ligaments in the knee
◼ Anterior drawer sign
◼ Posterior drawer sign

20. Anterior drawer sign
▣ Forward sliding of the tibia
on the femur
▣ Due to a rupture of the
anterior cruciate ligament

21. Posterior drawer sign
▣ Backward sliding of the tibia on the femur
▣ Due to rupture of the posterior cruciate ligament

22. Drawer Sign Anterior Posterior
Sliding of Tibia
relative to femur
Forward Backward
Ligament ruptured Anterior Cruciate
ligament
Posterior Cruciate
ligament

23. Unhappy Triad
▣ Occurs during sports when the knee is struck from the
lateral side
▣ Characterized by injury to the following
◼ Medial collateral ligament
◼ Anterior cruciate ligament
◼ Medial meniscus

25. Deformities of the Knee joint
▣ Genu Valgum (Knock-Knee)
▣ Genu Varum (Bowleg)

28. Genu Valgum
▣ Deformity in which the tibia is bent or twisted laterally
▣ It may occur as a result of collapse of the
lateral compartment of the knee and
rupture of the medial collateral ligament

29. Genu Varum
▣ Deformity in which the tibia is bent medially
▣ It may occur as a result of collapse of the medial
compartment of the knee and rupture of the lateral
collateral ligament.

31. ▣ Herniation occurs when the
contents of the
abdomen escape the abdominal
cavity
through a weakness in the
abdominal wall
▣ More common in women than in
men
▣ The abdominal contents pass
through the Femoral ring and
canal, and lie lateral and inferior
to the pubic tubercle and deep
and inferior to the inguinal
ligament
Femoral Hernia

34. Compartment Syndrome
▣ Increased pressure within one of the body's anatomical
compartments
▣ Since compartments are enclosed spaces that cannot
expand, an increase in pressure will compress the arteries
and nerves within it
▣ Most commonly affects lower limb.
▣ This can lead to insufficient blood supply to the tissue within
that space
▣ It is associated with extreme pain and may lead to necrosis
of tissue within the affected compartment

36. • The pressure in the limb can
be measured.
• Pressure more than 30mmHg
of mercury is diagnostic of
compartment syndrome.
• Compartment syndrome is
treated by Fasciotomy
(Making an incision in the
fascia to relieve the pressure)

38. Sciatic Nerve Injury
▣ Leads to
◼ Impaired extension at the hip
◼ Impaired flexion at the knee
◼ Loss of dorsiflexion/Planter flexion
at the ankle (causes Foot Drop)
◼ Loss of inversion/ eversion of the
foot
▣ Patient develops a unique gait
because of increased flexion at
the hip to lift the dropped foot off
the ground.

39. Sciatica
▣ This is the name given to a specific pain felt in the lower
back and hip, which radiates down the gluteal region and
into the thigh and lower leg.

40. Sciatica
▣ Occurs due to Compression of the sciatic nerve, usually
due to a herniated intervertebral disk between the L4-L5
or L5-S1 intervertebral space
▣ Causes muscular weakness, numbness, tingling, and
pain along the path of the sciatic nerve

43. Common Peroneal (Fibular) Nerve
Injury
▣ Due to Fracture of the head or neck of the fibula (Nerve
passes behind the head of the fibula and then winds
laterally around the neck of the fibula)
▣ Nerve damage results in foot drop (loss of dorsiflexion) and
loss of sensation on the dorsum of the foot and lateral
aspect of the leg
▣ Causes paralysis of all muscles in:
◼ The Anterior compartment of the leg (Innervated by Deep branch)
◼ The Lateral Compartment of the leg (Innervated by Superficial
branch)