injuries膝关节损伤课件

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1、KneeInjuriesImportantStructuresCruciateligamentsCollateralligamentsMenisciArticularcartilagePatellartendonCruciateligamentsControlanteriorandposteriormovementsFitinsidetheintercondylarfossaCollateralligamentsControllateralmovementExposedtovalgus(MCL)andvarus(LCL)forcesMenisc

2、iWeightdistributionWithoutmeniscitheweightofthefemurwouldbeconcentratedtoonepointonthetibiaConvertsthetibialsurfaceintoashallowsocketOtherImportantStructuresArticularcartilage1/4inchthicktoughandslickPatellaandpatellartendonTibialtuberoscityPatellofemoralgroovePatellaactslik

3、eafulcrumtoincreasetheforceofthequadricepsmusclesLigamentsKneeislikearoundballonaflatsurfaceLigamentsprovidemostofthesupporttothekneesLittlestructureorsupportfromthebonesMusclesQuadriceps-extensionHamstrings-flexionITbandfromthegluteusmaximusandtensorfascialataeAcuteKneeInju

4、riesAnteriorCruciateLigamentTearsCanwithstandapproximately400poundsofforceCommoninjuryparticularlyinsports(3%ofallathleticinjuries)Mayheara‘pop’soundandfeelthekneegiveawayTypesofACLTearsCausesofACLInjuriesCutting(rotation)HyperextensionStraightkneelandingWhenthekneeisextende

5、d,theACLisatit’smaximallengthputtingitatanincreasedriskoftearingExternalfactorsAmountoflowerbodystrengthFootwearandsurfaceinteractionUnhappyTriadACLMedialcollateralligamentMedialmeniscusLachmanTestandAnteriorDrawerTestNormalkneeshave2-4mmofanteriortranslationandasolidendpoin

6、tACLinjurywillhaveincreasedtranslationandasoftendpointWomenandACLTearsAnteriorCruciateLigamentInjuriesinFemaleAthletes:WhyAreWomenMoreSusceptible?JamesL.Moeller,MD;MaryM.Lamb,MDTHEPHYSICIANANDSPORTSMEDICINE-VOL25-NO.4-APRIL97NCAAFourtimesmoreACLtearsinwomenthanmenbasketballp

7、layers.Threetimesmoreingymnasts2.4timesmoreinsoccerHigherratesarealsofoundamongwomeninteamhandball,volleyballandalpineskiingFactorsSmallersizeofACLSmallerintercondylarnotchLargerQ-angle(doubtful)normal=17degreesinwomenNormal=14degressinmenFactorsWeakerhamstringsRatioof10(qua

8、driceps)to7(hamstrings)HormonesEstrogen–reducescollagenstrengthRelaxinACLRe