Hudes Karen
Private practice, 168 Sheppard Avenue West, Toronto, Ontario M2N 1M8; E-mail:
J Can Chiropr Assoc. 2011 Jun;55(2):120-7.
This case study chronicled the assessment, treatment and management of two adolescent patients presenting with acute knee pain, diagnosed as medial meniscus tear, with or without a medial collateral ligament sprain, with coronary ligament involvement.
Patient 1: A 16 year old male football player presented with right medial knee pain of 2 days duration after having been tackled during practice from the left side. Patient 2: A 16 year old female presented with right medial knee pain that began 1 week prior to presentation after a fall down the stairs.
Treatment was initiated in both cases using inflammatory control techniques of icing and fascial stripping and progressed to rehabilitative exercises including VMO (vastus medialis oblique) exercises and squatting exercises to strengthen the quadriceps femoris musculature and proprioceptive exercise. Rehabilitation occurred over a four week duration in both cases with progression of exercises on an individual basis. Both cases resolved within four weeks and return to normal activities resumed at the three week mark including a return to play in patient 1. Both patients reported complete resolution of symptoms at the four week mark with no recurrence on follow up a number of months later.
Conservative management, including icing, fascial stripping, and rehabilitative exercises may be beneficial in the treatment of medial meniscus tears with coronary ligament involvement in adolescents.
本病例研究记录了两名青少年患者的评估、治疗和管理过程,这两名患者均表现为急性膝关节疼痛,被诊断为内侧半月板撕裂,伴有或不伴有内侧副韧带扭伤,并累及冠状韧带。
患者1:一名16岁的男性足球运动员,在训练中从左侧被绊倒后,右侧膝关节内侧疼痛持续了2天。患者2:一名16岁的女性,在从楼梯上摔下后,于就诊前1周开始出现右侧膝关节内侧疼痛。
在这两个病例中,均首先采用冰敷和筋膜剥离等炎症控制技术进行治疗,随后进展为康复锻炼,包括股内侧斜肌(VMO)锻炼和深蹲锻炼,以增强股四头肌肌肉组织和本体感觉锻炼。两个病例的康复均持续了四周,锻炼根据个体情况逐步推进。两个病例均在四周内康复,在三周时恢复正常活动,包括患者1恢复比赛。两名患者均在四周时报告症状完全缓解,数月后的随访中无复发。
保守治疗,包括冰敷、筋膜剥离和康复锻炼,可能对青少年内侧半月板撕裂累及冠状韧带的治疗有益。