Page 1 of 1: # management

HANNA · Credits: 1064226 My Scrapbook

5.Management of #
A 20 y/o athlets twists his knee while skiing. exam reveals that drawer's sign is positive with tibia sliding anteriorly?

A Bed rest
B Kocher's manoeuver.
C physiotherapy
D vigorous exercise
E open reduction+K wire
F open reduction+internal fixation
G Reconstruction with graft.
H ligament repair
I no active intervention
J AO cannulated screws.

archan · Credits: 1276 My Scrapbook

ACL tear??
conservative - bed rest and physical therapy
interventional- reconstruction with graft
so maybe G

Most of ACL injuries are a result of low velocity, deceleration, rotational injuries and frequently are non contact injuries. The patient relates a pop at the time of injury and most of them are not able to return to sport immediately after the injury and this creates an acute onset of swelling. Associated injuries are common including meniscal tears and about 50-75% of these will bear ACL injuries, and combined ligamentous injury including medial collateral ligament, lateral collateral ligament or posterior cruciate ligament. Clinically, the presence of a positive Lachman test, anterior drawer's sign, or a pivot shift, is indicative of a torn ACL. MRI is the best non invasive tool for diagnosis.

Treatment
Conservative treatment with anti-inflammatory medication, icing, rest and physical therapy in very stiff knees is indicated as initial therapy for all ACL tears. Supplementation with a brace helps decrease the anterior translation of the tibia.
Surgical treatment should be tailored to each patient for the indication and the type of reconstruction. Many surgical treatment options exist. Primary repair is no longer a viable option. Extra-articular reconstructions are no longer in use except for very limited cases including open growth plates in very young patients.
Intra-articular reconstruction has become the gold standard for active patients with ACL injuries.

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