Knee and ankle ligament injuries

 

Knee & Ankle Ligament Injuries: NEET PG Essentials

1. Knee Ligament Injuries

Ligament Clinical Test
ACL (Anterior Cruciate) Anterior Drawer Test and Lachman Test (most sensitive).
PCL (Posterior Cruciate) Posterior Drawer Test and Posterior Sag Sign.
MCL (Medial Collateral) Valgus Stress Test.
LCL (Lateral Collateral) Varus Stress Test.

2. Ankle Ligament Injuries

  • Most Common Injury: Inversion ankle sprain, affecting the ATFL (Anterior Talofibular Ligament) first.
  • Injury Sequence: ATFL → CFL (Calcaneofibular ligament) → PTFL (Posterior Talofibular ligament).
  • High-Yield Tests:
    • Anterior Drawer Test (Ankle): Assesses ATFL integrity.
    • Talar Tilt Test: Assesses CFL integrity.

3. Examination Pearls

  • O’Donoghue’s Unhappy Triad: Classic injury combination of ACL, MCL, and Medial Meniscus tears.
  • Syndesmotic (High Ankle) Sprain: Involves the distal tibiofibular ligaments; diagnosed with the External Rotation Stress Test and Squeeze Test. Prolonged recovery compared to standard sprains.
  • Grade I–III Classification: Used for all ligamentous injuries (Grade I: stretch, Grade II: partial tear, Grade III: complete rupture).
  • RICE Therapy: Rest, Ice, Compression, Elevation remains the first-line treatment for acute grades I/II injuries.