- Ligament rupture of the knee - the degree and types of injury
The knee joint and its ligaments
The knee joint is formed by three bones: the femur, tibia and patella. The joint is reinforced by intra-articular and extra-articular ligaments. For intra include front and rear cruciate ligament. Anterior cruciate ligament starts from the inner surface of the end of the femur and attached to the front surface of the tibia. The posterior cruciate ligament originates on the outer surface of the end of the femur and attached to the rear surface of the tibia.
Extra-articular ligaments that strengthen the knee joint are the peroneal and tibial collateral (side) ligaments, oblique popliteal and arcuate ligament, patellar tendon. Fibular lateral ligament starts from the outer end of the femur and attached to the outer surface of the head of the fibula. This bundle is separated from the capsule of the knee joint subcutaneous tissue. Tibial collateral ligament is located on the inner surface of the joint and has a view of the fibrous plate widths up to 12 mm, spliced with the capsule of the joint, and through it to the inner meniscus (crescent-shaped cartilage located at the side of the inside of the knee joint). At the top it is attached to the inner end of the femur, and at the bottom - to the inner end of the tibia.
Types ligament injuries of the knee joint
Most injured tibial (inner) side is attached to a bunch of her articular capsule and medial meniscus. Further, the frequency should be combined damage to the side of the tibia and the anterior cruciate ligament, much less damaged by the outer lateral ligament.
There are four degrees of destruction of joints and ligaments of the knee:
- Grade I - stretch,
- Grade II - partial ligament tear or detachment and capsules
- Grade III - complete tear or detachment of the capsule ligament damage,
- Grade IV - sochetannyj breaking extra-articular and intra-articular ligaments with extensive damage to the capsule and meniscus.
Extra-articular lesions collateral (side) ligaments of the knee joint
I and II degree of damage is accompanied by lateral ligaments soreness at the site of ligament damage - in the area of the inner end of the femur with the tibia ligament damage on the interior, and in the outer surface of the fibular head is damaged fibula external lateral ligament. The pain is worse when you try to make a lateral and rotational movement of the lower leg, although painful mobility of the lower leg is not.
A complete break or come loose lateral ligaments (III degree) at the time the injury appears severe pain, and there is a sense of cod displacement of the articular surfaces. Typically, in this joint capsule is broken, and often injured, one or both of the meniscus. At the site of injury appear edema
Prevention and treatment of edema - it is important to understand the root cause
and bleeding, which may spread to the area of the joint (hemarthrosis). The knee joint becomes unstable. Passive rotation of the tibia increases, while returning lower leg to the starting position there is a characteristic sound of the articular surfaces.
Isolated full break fibular ligament outer side - very rare. Often there detachments of the ligament with a bone plate from the head of the fibula. It is often injured peroneal nerve.
When the IV degree of damage to the signs of complete rupture of the lateral ligaments are attached signs cruciate ligament rupture, due to which increases the instability of the joint and the amount of passive movements.
Treatment depends on the extent of ligament damage. When I degree damage to the knee joint superimposed compressive bandage and recommended a temporary unloading of limbs (walking on crutches). At the II degree after anesthesia in the joint area overlaps the plaster in unbent position for two to three weeks. If grade III-IV immobilization extended to four to six weeks. Athletes and young adults with acute preferably operative treatment: stitching the torn capsule and ligaments with additional plastics and removal of meniscus.
Damage intra cruciate ligament of the knee
Often traumatic front, at least - back and very rare - both ligaments. Isolated cruciate ligament tears occur in four to five times less often in combination with other injuries. The diagnosis in the early days it is difficult to deliver because of haemarthrosis (the presence of blood in the joint). After the acute symptoms subside, there are signs of intra-articular ligament damage: increased mobility in the knee joint in the anteroposterior direction (the symptoms of "the front and rear of the drawer"), an increase in the rotation angle into the lower leg, increased razgibaemost knee.
Treatment of fresh cruciate ligament tears are usually conservative. Plaster cast is applied to the femur and tibia in flexion to 170˚ for a period of 4-6 weeks. If no effect is performed plastic surgery recovery ligaments. Plastic is also carried out at the chronic ruptures cruciate ligament.
In order not to create additional problems themselves, torn ligaments of the knee joint to be treated immediately after injury.