الفهرس 
INTRODUCATIONOnly 14 pages are availabe for public view
 |  | from | 225 |  |  |
| | | from | 225 | | |
Abstract
The treatment of anterior cruciate ligament (ACL) disruption presents a frustrating problem for the orth¬opedic surgeon. So, in order to plane a regimen for treating ACL injuries, We have to know every thing about this ligament The ACL is a multifascicular structure whose femoral and tibial attachments, as well as spatial or¬ientation within the knee, are directly related to its function as a constraint of joint motion. The ACL is made up of multiple collagen bundles that give rise to the mUltifascicular nature of the ligament 0 This arr¬angement results, in a different portion of the ligam¬ent being taut and therefore functional, throughout the rang of motion 0 The blood supply is predominantly of soft tissue origin (from the covering synovial mem¬brane) opposing to the osseous supply 0 The nerve supply originates from the tibial nerve having vasomotor, pro¬prioceptive and sensory functions 0 The principal role of the ACL is to resist ant¬erior displacement of the tibia on the femur 0 The ACL also has a major role in resisting internal rotation 0 -The posterior fibres are longest, or most :tense in ex¬tension, and are therefore the major resistance to hyperextension and are more susceptible to injury in extension 0 The anterior fibres are longest, or most tense, in flexion, and therefore are more susceptible to injuries with the knee flexed 0 There are four mechanisms of injury of ACL which are : external rotation and abduction forces while the knee in flexion, complete dislocation of the knee, direct posterior violence and •rotation sec¬ondary to longitudinal meniscal tear 0 Modes of ACL failure are : ligamentous failure, tibial avulsion fracture, combination of the previous 2 modes, femo¬ral avulsion fracture and combined ligamentous fail¬ure and femoral avulsion fracture 0 For Diagnosis, a careful history often gives important clues and the main symptoms are 0 Pain , swelling and giving way 0 In order to examine the knee, we have to proceed in a stepwise manner in order to avoid Omission 0 A positive anterior drawer test indicates a tear of anteromedial band (AMB) or in more sever injuries , the entire ACL 0 The value of lachman test is to de¬tect partial damage of ACL which is injury of AMB 0 Various tests are used tp evaluate rotatory instabi¬lity 0 Anteromedial rotatory instability is detected