Knee and Leg Fractures

Published on 16/04/2015 by admin

Filed under Surgery

Last modified 16/04/2015

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25 Knee and Leg Fractures

Anatomy of Knee and Leg

image

Bones of the Leg (Right)

Patella

• Largest sesamoid bone, attached between quadriceps and patellar tendons
• Patellar tendon attaches to tibial tuberosity.
• Inferior (deep) surface is hyaline cartilage that articulates with femoral condyles as part of complex knee joint.

Tibia

• Parts and landmarks: intercondylar eminence (plateau), lateral and medial intercondylar tubercles, lateral and medial condyles, Gerdy’s tubercle (iliotibial tract insertion), tibial tuberosity, anterior border; lateral, medial, and posterior surfaces; interosseus border, soleal line, fibular notch, medial malleolus, inferior articular surface (for talus)

Fibula

• Parts and landmarks: apex, head, neck, interosseus border, medial crest, posterior border, lateral malleolus, malleolar fossa
image

Knee Joint

Knee Joint(s)

• Fibrous capsule provides relatively little support to complex knee joint.
• Patellofemoral joint: synovial articulation between patella and femoral condyles
• Medial meniscus

image Articular fibrocartilage between medial femoral and tibial condyles
image More crescent-shaped, attached to tibial collateral ligament

• Lateral meniscus

image Articular fibrocartilage between lateral femoral and tibial condyles
image More circular

• Transverse meniscal ligament: between anterior aspects of menisci; stabilizing
• Posterior meniscofemoral ligament (of Humphrey): from posterior lateral meniscus to medial femoral condyle; stabilizing
• Anterior cruciate ligament (ACL): from posteromedial aspect of lateral femoral condyle to anteromedial tibial eminence
• Posterior cruciate ligament (PCL): from lateral aspect of medial femoral condyle to posteromedial tibial eminence
• Tibial (medial) collateral ligament

image Medial femoral epicondyle to medial tibia and medial meniscus
image Resists valgus angulation

• Coronary ligament: stabilizes medial meniscus
• Pes anserinus

image Distal tendons of sartorius, gracilis, and semitendinosus inserting on medial subcondylar tibia, superficial to collateral ligaments
image Resists valgus angulation

• Lateral (fibular) collateral ligament

image Lateral supracondylar femur to fibular head
image Resists varus angulation

image

Leg: Cross Section and Compartments

Compartments of the Leg

• Crural fascia

image Tough, nonexpansible, deep fascial sheath surrounds leg compartments, attached to the tibia anteriorly
image Continuous with fascia lata above knee
image Fuses with deep intermuscular septa surrounding compartments

• Anterior compartment

image Ankle/foot (plantar) extensor muscles: tibialis anterior, extensor digitorum longus, extensor hallucis longus, peroneus (fibularis) tertius (when it exists)
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