The document discusses various types of knee injuries, including fractures of the femoral and tibial condyles, patella fractures, injuries to the extensor mechanism, internal derangements of the knee, and knee dislocations. It provides details on the mechanisms, clinical features, and treatment approaches for each type of injury.
In the elderly osteoporotic fractures although the principles are the same but some special considerations in management of the soft tissues and the bony injuries are considered.
Can read freely here
https://sethiortho.blogspot.com/
Fracture Healing and
Mechanical stability
Perren`s strain theory
Fracture healing
Indirect Healing
Direct healing
Fixation techniques and stability
Nonunion and Management
Fracture healing
Biological environment
Age
Nutritional status
Blood supply
Metabolic
Mechanical stability
Absolute
Relative
Surgical procedure
Alters biological environment
Selection of fixation
Alters mechanical environment
Mechanical Stability
Parren's strain theory
Strain
Relative deformation of a material when a given force is applied
Relative changes in the fracture gap divided by original fracture gap = L / L
Stability determines the Strain at the fracture site
Stable fixation – less strain
Unstable fixation – high strain
Large gap fracture – less strain
Cross section of the fracture-
Fracture gap strain VS cells response
The degree of inter fragmentary strain appears to govern the cellular response.
Each of these tissues is able to tolerate a different amount of strain:
Perren's strain theory….
When the inter fragmentary strain is <2% bone repair occurs by direct healing
While for intermediate amount of IFS (5–10%) the fracture heals by indirect healing.
Stain theory of healing –Indirect healing
Indirect Healing
Indirect Healing…
Hard callus formation
Indirect Healing
Remodeling Stage
Months to years
Conversion of woven bone into lamellar bone
Formation of Medullary cavity
Return of biomechanical property
Influenced by wolf law – Remodeling based on stress
Stain theory of healing…pseudo arthrosis
Complete instability
Callus is unable to form because the strain is too much for it to tolerate.
The more strain-tolerant fibrous tissue forms
Bone ends are sealed over with cortical bone
Formation of false joint with synovial fluid in the gap
Hypertrophic nonunion
Unstable fracture
Excess callus formation unable to reduce the IFS
Creates a hypertrophic non union
Direct Healing
Anatomically reduced rigid fixed fractures
Formation of cutting cones
>100,000 remodeling units work at time
Direct osteonal remodeling
Without callous
Activation
resorption by osteoclasts
osteoid formation by osteoclasts
Primary osteons
Mineralization
Direct Healing….
Fixation techniques and stability
Relative stability
Intramedullary nailing
Load sharing device
Inter fragmentary micro motion
Fracture gap strain is usually 2-10%
Body responds by forming more soft callus to try and decrease the strain
Fixation of diaphyseal fractures – strength and less duration
Relative stability
Absolute stability
Absolute stability
TBW
Lag screw fixation
Interfragmentary strain,
Nonunion and Management
Nonunion ….
Fracture is fixed rigidly but a gap is present
Direct healing may not be able to bridge the gap
The lack of strain may inhibit callus formation and secondary healing
Predispose to non-union
Management –
In the elderly osteoporotic fractures although the principles are the same but some special considerations in management of the soft tissues and the bony injuries are considered.
Can read freely here
https://sethiortho.blogspot.com/
Fracture Healing and
Mechanical stability
Perren`s strain theory
Fracture healing
Indirect Healing
Direct healing
Fixation techniques and stability
Nonunion and Management
Fracture healing
Biological environment
Age
Nutritional status
Blood supply
Metabolic
Mechanical stability
Absolute
Relative
Surgical procedure
Alters biological environment
Selection of fixation
Alters mechanical environment
Mechanical Stability
Parren's strain theory
Strain
Relative deformation of a material when a given force is applied
Relative changes in the fracture gap divided by original fracture gap = L / L
Stability determines the Strain at the fracture site
Stable fixation – less strain
Unstable fixation – high strain
Large gap fracture – less strain
Cross section of the fracture-
Fracture gap strain VS cells response
The degree of inter fragmentary strain appears to govern the cellular response.
Each of these tissues is able to tolerate a different amount of strain:
Perren's strain theory….
When the inter fragmentary strain is <2% bone repair occurs by direct healing
While for intermediate amount of IFS (5–10%) the fracture heals by indirect healing.
Stain theory of healing –Indirect healing
Indirect Healing
Indirect Healing…
Hard callus formation
Indirect Healing
Remodeling Stage
Months to years
Conversion of woven bone into lamellar bone
Formation of Medullary cavity
Return of biomechanical property
Influenced by wolf law – Remodeling based on stress
Stain theory of healing…pseudo arthrosis
Complete instability
Callus is unable to form because the strain is too much for it to tolerate.
The more strain-tolerant fibrous tissue forms
Bone ends are sealed over with cortical bone
Formation of false joint with synovial fluid in the gap
Hypertrophic nonunion
Unstable fracture
Excess callus formation unable to reduce the IFS
Creates a hypertrophic non union
Direct Healing
Anatomically reduced rigid fixed fractures
Formation of cutting cones
>100,000 remodeling units work at time
Direct osteonal remodeling
Without callous
Activation
resorption by osteoclasts
osteoid formation by osteoclasts
Primary osteons
Mineralization
Direct Healing….
Fixation techniques and stability
Relative stability
Intramedullary nailing
Load sharing device
Inter fragmentary micro motion
Fracture gap strain is usually 2-10%
Body responds by forming more soft callus to try and decrease the strain
Fixation of diaphyseal fractures – strength and less duration
Relative stability
Absolute stability
Absolute stability
TBW
Lag screw fixation
Interfragmentary strain,
Nonunion and Management
Nonunion ….
Fracture is fixed rigidly but a gap is present
Direct healing may not be able to bridge the gap
The lack of strain may inhibit callus formation and secondary healing
Predispose to non-union
Management –
Bone fractures are a very common orthopedic injury resulting from trauma and sudden loads or stresses applied to bones or a result from bones being weakened by certain diseases. More than 250,000 femur fracture patients are seen per year in the U.S. on average. Bone fractures are either a complete or partial break in a bone and in some cases a simple cast to immobilize the injury site is not enough to completely heal the fracture.
Immobilization from casts may not be enough to completely heal the fracture if a malunion (when both ends of the fractured bone misalign) occurs and/or if a non-union (when the fracture gap is too large and the fractured ends cannot re-attach to one another) occurs. In the case of a malunion or non-union, a possible solution to the problem is by surgically inserting an intramedullary rod into the center canal (diaphysial) region of the injured bone and fixating it into place with screws.
Approach to acute knee injuries (knee injury)mahadev deuja
approach to acute knee injuries include detail history, focused knee exam and imaging/invasive procedure,Diagnosis is made at history most of the times.History should include mechanism of Injury,location of pain, mechanical symptoms like swelling/ effusion...
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Important surgical approaches to acetabulum and pelvis are described.
Ilioinguinal approach, Modified Stoppa Approach, Kocher lagenbeck Approach, Ilifemoral approach and extensile approaches are well illustrated and described.
The presentation investigates the following characteristics of the meniscus;
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Hoffa's Fracture: Diagnosis, management & New Classification System by BAGARI...Vaibhav Bagaria
Hoffa's Fracture - coronal split fracture of distal femur, its diagnosis, management strategy, a new classification and tips and tricks of management. First described Hoffa, a new classification system by Bagaria et al helps plan the surgery for these tricky fracture. The most crucial step is not to miss these fractures in ER.
Bone fractures are a very common orthopedic injury resulting from trauma and sudden loads or stresses applied to bones or a result from bones being weakened by certain diseases. More than 250,000 femur fracture patients are seen per year in the U.S. on average. Bone fractures are either a complete or partial break in a bone and in some cases a simple cast to immobilize the injury site is not enough to completely heal the fracture.
Immobilization from casts may not be enough to completely heal the fracture if a malunion (when both ends of the fractured bone misalign) occurs and/or if a non-union (when the fracture gap is too large and the fractured ends cannot re-attach to one another) occurs. In the case of a malunion or non-union, a possible solution to the problem is by surgically inserting an intramedullary rod into the center canal (diaphysial) region of the injured bone and fixating it into place with screws.
Approach to acute knee injuries (knee injury)mahadev deuja
approach to acute knee injuries include detail history, focused knee exam and imaging/invasive procedure,Diagnosis is made at history most of the times.History should include mechanism of Injury,location of pain, mechanical symptoms like swelling/ effusion...
Surgical Approaches to Acetabulum and PelvisBijay Mehta
Important surgical approaches to acetabulum and pelvis are described.
Ilioinguinal approach, Modified Stoppa Approach, Kocher lagenbeck Approach, Ilifemoral approach and extensile approaches are well illustrated and described.
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Hoffa's Fracture: Diagnosis, management & New Classification System by BAGARI...Vaibhav Bagaria
Hoffa's Fracture - coronal split fracture of distal femur, its diagnosis, management strategy, a new classification and tips and tricks of management. First described Hoffa, a new classification system by Bagaria et al helps plan the surgery for these tricky fracture. The most crucial step is not to miss these fractures in ER.
elbow and wrist and hand fracture with managementkajalgoel8
describing anatomy of the wrist and hand ..
what is fracture
mechanism of injury of all the fracture
classification of fracture
clinical features
radiologicals exminations
management of the fracture
This presentation is about anatomy of ankle, classification of ankle injuries, the clinical features with which patient will present, the examination and treatment of them and the complications associated.
A lysosomal storage disease caused by acid sphingomyelinase deficiency (ASMD), which catalyzes the hydrolysis of sphingomyelin (SM) to ceramide and phosphocholine.
Most pNENs - sporadical.
Some individuals may have a genetic predisposition to developing pNENs.
But may not be expressed unless it is triggered or activated under certain circumstances, such as due to certain environmental factors.
As part of a larger genetic syndrome such as; 1. Multiple endocrine neoplasia type I (MEN1), 2. Von Hippel-Lindau syndrome (VHL) or 3. Neurofibromatosis type I (NF-1).
Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs.
The disease can be either localized to the skin or involve other organs in addition to the skin.
Symptoms may include areas of thickened skin, stiffness, feeling tired, and poor blood flow to the fingers or toes with cold exposure.
Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome.
Characterised by numbness and tingling of the radial 3 ½ digits.
Found in 1% of the general population
Increased incidence is noted in women, the elderly and pregnant patients.
1. Undescended Testis : Along the normal path, but not reached scrotum.
2. Retractile Testis : Hyperreflexic Cremaster
3. Ectopic Testis : Deviation from normal path of descent
Absence of testis in scrotum since birth
Hemiscrotum empty, hypoplastic
Decreased caliber and force of the stream
Problems starting(hesitancy) and stopping urine stream; post-void dribbling
Impaired bladder emptying
- high risk of infection and hydronephrosis
Urinary retention
Incontinence
Nocturia; polyuria / Dysuria
Hypertrophy of bladder wall muscle
- increased risk for bladder diverticula
Microscopic hematuria maybe present
Scorpions are a common arthropod found all over the world.
If threatened, a scorpion may use its long, flexible tail to sting a potential predator.
Frequently, people unknowingly come into contact with these species and experience the painful sensation of envenomation
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. Injuries of the Knee
Groups;
1. Fracture of the Femoral condyles
2. Fractures of the Tibial condyles
3. Fracture Patella
4. Injuries to the extensor mechanism
5. Internal Derangements of the knee (I.D.K.)
6. Dislocation of the knee
1. Fracture of the Femoral Condyles
Can be fractured by
a. direct violence or
b. by sudden vulgus or varus strains on the knee joint.
Unicondylar
- Involving the medial or lateral condyle only
Bicondylar
- Extending in to the articular surface in a T or Y shaped manner.
- Hemarthrosis occurs always when the fracture line runs into the articular surface of the knee.
Treatment: a. Accurate anatomical reduction
b. Early mobilization of the joint
c. Delayed weight bearing
The displaced fragment is reduced by manipulation.
If the fragment is large and reduction is not possible,
-Open reduction and internal fixation with dynamic condylar screw system will be necessary.
2. 2. Fracture of the Tibial Condyles
Unicondylar
Bicondylar
Types are: i) Undisplaced crack fracture
ii) Displaced or depressed fractures with or without comminution.
Mechanism and Clinical features
- A sudden vulgus strain of the knee due to direct injury on the lateral aspect of the knee when the
patient is standing, causes a depressed fracture of the lateral condyle of the tibia.
-Depending on the severity of the valgus violence, the medial collateral ligament and anterior cruciate
ligament may get damaged.
-May also be complicated by a fracture neck of the Fibula and injury to the lateral popliteal nerve.
-The patient presents with a swollen knee and evidence of local contusion on the lateral aspect and
hemarthrosis.
Treatment: i) Unicondylar Fracture with minimal displacement
-The fragment may be restored by traction and direct compression. The leg is
immobilized in an above knee plaster slab.
ii) Cases with a marked depression of the condyle
-Surgical elevation to restore articular congruity and internal fixation with special T
shaped buttress plate and screws is done.
3. Fracture Patella
The Biggest sesamoid bone in the body.
Being incorporated in the quadriceps muscle, it improves the leverage for the action of its tendon by
altering favourably the line of insertion of the tendon.
Mechanism
a. Muscular Violence
- A sudden contraction of the muscle to prevent a fall causes a transverse fracture of the
3. patella, along with a tear of the medial and lateral retinacula of the quadriceps expansion.
- The fracture may be across the middle of the patella or near the lower pole.
b. Direct Violence
- A direct injury on the patella due to a fall on the knee usually produces a stellate
fracture of the patella with a comminution of the bone.
- The quadriceps expansion is intact.
Clinical Features
- A history of a feeling of something giving away in the knee, when attempting to avoid a fall
or a fall directly on the knee.
- Swollen knee and evidence of Hemarthrosis in the joint.
- Presence of bruises over the surface indicates direct violence.
- A transverse line of tenderness across the patella on palpating the bone.
- If the fragments are separated,a gap could be felt between the two fragments and there will
be inability to actively extend the knee.
Radiographs
- Can distinguish which type is it
a. Transverse fracture
b. Fracture of the upper or lower pole
c. Comminuted fracture
Treatment
i) Transverse Crack Fracture
- The hemarthrosis is aspirated and the knee immobilized in a tube plaster cast for
about 4 weeks.
ii) Transverse fracture with separation
- Always means that the quadriceps expansions are ruptured. Need operative
treatment to repair and restore the quadriceps mechanism.
- Patellar fragments are brought together and sutured with stainless steelwire in a
circumferential or in a figure 8 manner.
- The medial and lateral quadriceps expansions are carefully sutured.
iii) Comminuted fracture
- Here,the fracture with displacement, the articular surface is badly damaged.
Treatment is Patellectomy and repair of quadriceps mechanism.
iv) Fracture lower pole
- The small lower pole fragment is excised and the ligamentum patellae is attached to
the main fragment.
4. 4. Injuries of the Extensor Mechanism
It consists of the; a. Quadriceps muscle
b. The patella
c. Ligamentum patellae
d. The medial retinacula
e. The lateral retinacula
Injuries could be;
i) Rupture of the quadriceps muscle
ii) Fracture of the patella
iii) Avulsion of its insertion
Rupture of the quadriceps muscle occurs due to sudden violent contraction.
Usually occurs at the upper border of the patella.
Rupture across the ligamentum patellae has the same effect.
There is an inability to actively extend the knee.
In both cases the surgical repair is indicated.
5. Dislocation of the Knee
Traumatic dislocation of the knee is an uncommon injury.
It is caused by road traffic accidents and sometimes in sports injury.
According to the direction of the displacement of the tibia;
a. Anterior
b. Posterior
c. Lateral
d. Medial
6. Traumatic Dislocation of Patella
A rare condition where the patella gets laterally dislocated due to sudden quadriceps contraction.
Mostly it is easily reduced.
It leaves the patient with a sense of knee giving way and an apprehension of instability.
If patient presents with an acute dislocation of patella, it is reduced under generalanesthesia
Rivin..®