Knee and Leg Fractures

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)

image Vessels: anterior tibial artery and vein

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Aug 12, 2016 | Posted by in ANATOMY | Comments Off on Knee and Leg Fractures

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