MANUAL MINORS
Knee injuries are common in emergency settings due to the knee’s high susceptibility to trauma and sports-related injuries. As an emergency physician in an A&E department, it is crucial to correctly identify and classify these injuries to ensure appropriate treatment and prevent long-term complications. Below is a description of each type of knee injury from the perspective of an emergency physician.
Category | Description |
|---|---|
Knee Fractures | |
Patellar Fracture | Fracture of the kneecap caused by direct trauma or falls. Symptoms include severe pain at the front of the knee, swelling, and difficulty extending the leg. |
Distal Femoral Fracture | Fracture at the lower end of the femur near the knee joint. Symptoms include severe knee pain, swelling, and deformity of the thigh. |
Proximal Tibial Fracture | Fracture at the upper end of the tibia, just below the knee. Symptoms include severe pain, swelling in the knee and tibia, and difficulty bearing weight. |
Ligament Injuries | |
Anterior Cruciate Ligament (ACL) Injury | ACL tear, common in sports involving sudden movements. Symptoms include severe pain, rapid swelling, knee instability, and difficulty moving the leg. |
Posterior Cruciate Ligament (PCL) Injury | PCL tear due to direct trauma to the front of the knee. Symptoms include pain, swelling, and difficulty maintaining knee stability. |
Medial Collateral Ligament (MCL) Injury | MCL injury caused by a blow to the outside of the knee. Symptoms include pain on the inside of the knee, swelling, and tenderness. |
Lateral Collateral Ligament (LCL) Injury | LCL injury caused by trauma to the inside of the knee. Symptoms include pain on the outside of the knee, swelling, and tenderness. |
Cartilage Injuries | |
Meniscus Tear | Injury to the meniscal cartilage due to twisting or trauma. Symptoms include pain, swelling, knee locking, and difficulty moving the knee. |
Chondromalacia Patella | Softening of the cartilage beneath the kneecap. Symptoms include pain at the front of the knee, which may worsen when climbing stairs or sitting for long periods. |
Tendon Injuries | |
Patellar Tendonitis | Inflammation of the tendon connecting the kneecap to the tibia, common in athletes. Symptoms include pain at the front of the knee and tenderness to touch. |
Patellar Tendon Rupture | Tear of the tendon connecting the kneecap to the tibia, due to trauma or intense effort. Symptoms include severe pain, inability to extend the leg, and visible deformity at the front of the knee. |
Trauma Injuries | |
Contusion and Haematoma | Bruises and haematomas in the knee caused by direct blows or trauma. Symptoms include pain, swelling, and skin discolouration. |
Ligament or Cartilage Injury from Direct Trauma | Trauma-induced injuries to ligaments or cartilage, resulting in pain, swelling, and limited mobility. |
Management Protocol
Initial Assessment:
Clinical History and Physical Examination: Evaluate the mechanism of injury, pain, knee function, and look for signs of complications.
Immobilisation: Use splints or devices to stabilise the knee and reduce pain.
Diagnostic Imaging:
X-rays: To identify bone fractures and assess knee alignment.
MRI: To evaluate ligament, meniscus, and cartilage injuries.
Initial Treatment:
Pain Management: Administer analgesics and anti-inflammatory medications.
Soft Tissue Injury Treatment: Apply ice, elevate the leg, and use compresses to control swelling.
Surgical Intervention:
Fractures and Severe Injuries: Surgery may be necessary to realign fractured bones or repair torn ligaments and tendons.
Rehabilitation and Follow-up:
Physical Rehabilitation: To restore knee mobility and strength.
Ongoing Monitoring: Assess recovery and prevent long-term complications.
Each knee injury must be carefully managed to ensure optimal recovery and restore the patient’s functionality.
Comments