CLINICAL CASE SCENARIO KNEE INJURY-ANTERIOR CRUCIATE LIGAMENT TEAR
A 25-year-old man has been hurt during football match by his opponent player.He falls and twists his right leg.On examination, the right knee is swollen and tender. With the patient sitting on the stretcher with his knee flexed, the lower leg seems to have several centimeters of excess anterior mobility.
Most likely diagnosis: Anterior cruciate ligament (ACL) tear
Mechanism of injury: Excessive rotational force strains or ruptures the ligament
CLINICAL CORRELATION
Injuries to the knee are very common because it bears weight, combines mobility in flexion and extension, and allows some rotation. The stability of the knee depends entirely on its ligaments and muscles. Sports injuries to the knee are most commonly caused by high-speed and rotational forces applied to the leg through the knee joint. In addition, certain ligaments are anatomically related to the menisci, on which the distal femur articulates. This 25-year-old man was involved in a football match, a common setting for ACL injury. The ACL passes from the posterior aspect of the distal femur to the intercondylar region of the anterior aspect of the proximal tibia; it limits anterior movement of the tibia in relation to the femur. Thus, on examination, this patient exhibits the “anterior drawer sign,” or excessive anterior mobility of the tibia with the knee flexed. This injury will usually require surgical repair.
