Manoeuvre for diagnosing rupture of medial collateral ligament is: March 2010
Ans. D: Valgus Stress Test Tests to Detect Ligament Injury Lachman Test - The Lachman test is the best test to diagnose an ACL tear. - With the patient lying flat and relaxed, the examiner bend the knee slightly, about 20 degrees. The examiner then stabilizes the thigh while pulling the shin forward. - Both the amount of translation (shifting) as well as the feel of the endpoint offer information about the ACL. Anterior Drawer Test - The anterior drawer test is also performed with the patient lying flat. The knee is bent 90 degrees and the shin is pulled forward to check the stability of the ACL. - An intact ACL will only allow the shin to come forward slightly. - A torn ACL will allow the shin to move fuher forward. Pivot Shift Test - The pivot shift test is a difficult maneuver to perform on a patient who is not under anesthesia. This test places a stress on the knee joint that forces a subluxation (paial dislocation) in patients who do not have an ACL. - This test recreates the type of instability that caused the ACL injury. Posterior Drawer Test - The posterior drawer is performed similarly to the anterior drawer test. - This test detects injury to the PCL. - By pushing the shin backward, the integrity of the PCL is tested. - Excessive movement of the shin backwards is a sign of PCL injury. Varus and Valgus Instability - Varus and valgus instability tests check the LCL (lateral collateral ligament) and MCL (medial collateral ligament), respectively. - With the patient lying flat, and the knee held at about 30 degrees of flexion, gentle adduction and abduction force is applied. - Insufficiency of the LCL or MCL will allow the knee to "open up" excessively. - The test is repeated with the leg straight. If the knee still opens up excessively, then more than just the LCL or MCL was torn.
Posterior drawer test
Anterior drawer test
Lachmann's test
Valgus stress test