Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training

Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examinatio...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Military medicine 2017-07, Vol.182 (7), p.e1924-e1928
Hauptverfasser: Crowell, Michael S, Mason, John S, Posner, Matthew A, Haley, Chad A
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page e1928
container_issue 7
container_start_page e1924
container_title Military medicine
container_volume 182
creator Crowell, Michael S
Mason, John S
Posner, Matthew A
Haley, Chad A
description Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury. With a PCL tear, patients rarely describe an audible "pop" that is commonly reported in ACL injuries. On physical exam, a frequent finding in PCL tears is a loss of 10 to 20° of knee flexion. Although the most common clinical tests for PCL tears include the posterior drawer test, the posterior sag sign, and the quadriceps active test, there is a lack of high-quality diagnostic accuracy studies. Two cases of U.S. Military Academy Cadets who sustained PCL injuries while removing combat boots during military survival swim training are presented. The results of the clinical examination are accompanied by magnetic resonance imaging results and intraoperative arthroscopic images to highlight key findings. Both patients were evaluated and diagnosed with PCL injures within 10 days of their injuries. Each reported feeling/hearing a "pop," which is atypical in PCL tears. Both patients demonstrated a lack of active and passive knee flexion, which is a commonly reported impairment. One patient was managed nonsurgically with physical therapy and eventually returned to full duty without limitations 9 months after his injury. The other patient, who sustained a combined PCL-PLC injury, underwent a PCL reconstruction and PLC repair and reconstruction 8 weeks after his injury. He returned all training, with the exception of contact/collision sports, 9 months after surgery. Both patient's rehabilitation programs consisted of a progression of exercises to improve range of motion, muscle strength/endurance, motor control, and muscular power. Military and sports medicine professionals should be aware of the potential for PCL injury with this unusual, and previously unreported, mechanism of injury during survival swim training. Prompt diagnosis and appropriate treatment is essential to prevent long-term disability.
doi_str_mv 10.7205/MILMED-D-16-00334
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1929898877</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1917823447</sourcerecordid><originalsourceid>FETCH-LOGICAL-c324t-eae87ad06800518eabddc99f04e09652180bebec8c065a524f756aec8f0db3633</originalsourceid><addsrcrecordid>eNpdkMtOwzAQRS0EoqXwAWyQJTZsDOM4cexl1Rao1AqkFsHOchKnuMoD7KSIvyd9wILVaDTnjmYOQpcUbuMAorv5dDafjMmYUE4AGAuPUJ9KBoRT9naM-gABJyHEUQ-deb8GoKEU9BT1AiEoSEn7aPlc-8Y4Wzs8cm1qdWPwzK50aaoGT6t166zxeOh9vZtl-NU273huC9to940XrdvYjS7w4suWeOm0rWy1OkcnuS68uTjUAXq5nyxHj2T29DAdDWckZUHYEKONiHUGXABEVBidZFkqZQ6hAcmjgApITGJSkQKPdBSEeRxx3fU5ZAnjjA3QzX7vh6s_W-MbVVqfmqLQlalbr6gMpJBCxHGHXv9D13Xrqu66jqKxCFgYbim6p1JXe-9Mrj6cLbtHFQW1Va72ytVYUa52yrvM1WFzm5Qm-0v8OmY_eSt9EQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1917823447</pqid></control><display><type>article</type><title>Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Crowell, Michael S ; Mason, John S ; Posner, Matthew A ; Haley, Chad A</creator><creatorcontrib>Crowell, Michael S ; Mason, John S ; Posner, Matthew A ; Haley, Chad A</creatorcontrib><description>Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury. With a PCL tear, patients rarely describe an audible "pop" that is commonly reported in ACL injuries. On physical exam, a frequent finding in PCL tears is a loss of 10 to 20° of knee flexion. Although the most common clinical tests for PCL tears include the posterior drawer test, the posterior sag sign, and the quadriceps active test, there is a lack of high-quality diagnostic accuracy studies. Two cases of U.S. Military Academy Cadets who sustained PCL injuries while removing combat boots during military survival swim training are presented. The results of the clinical examination are accompanied by magnetic resonance imaging results and intraoperative arthroscopic images to highlight key findings. Both patients were evaluated and diagnosed with PCL injures within 10 days of their injuries. Each reported feeling/hearing a "pop," which is atypical in PCL tears. Both patients demonstrated a lack of active and passive knee flexion, which is a commonly reported impairment. One patient was managed nonsurgically with physical therapy and eventually returned to full duty without limitations 9 months after his injury. The other patient, who sustained a combined PCL-PLC injury, underwent a PCL reconstruction and PLC repair and reconstruction 8 weeks after his injury. He returned all training, with the exception of contact/collision sports, 9 months after surgery. Both patient's rehabilitation programs consisted of a progression of exercises to improve range of motion, muscle strength/endurance, motor control, and muscular power. Military and sports medicine professionals should be aware of the potential for PCL injury with this unusual, and previously unreported, mechanism of injury during survival swim training. Prompt diagnosis and appropriate treatment is essential to prevent long-term disability.</description><identifier>ISSN: 0026-4075</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.7205/MILMED-D-16-00334</identifier><identifier>PMID: 28810991</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Accuracy ; Armed forces ; Biomechanics ; Education - statistics &amp; numerical data ; Epidemiology ; Humans ; Joint and ligament injuries ; Knee ; Knee Injuries - complications ; Knee Injuries - diagnosis ; Knee Injuries - surgery ; Male ; Military Personnel - statistics &amp; numerical data ; NMR ; Nuclear magnetic resonance ; Patients ; Posterior Cruciate Ligament - injuries ; Range of Motion, Articular - physiology ; Skin &amp; tissue grafts ; Sports injuries ; Swimming - injuries ; Swimming - physiology ; Trauma ; Young Adult</subject><ispartof>Military medicine, 2017-07, Vol.182 (7), p.e1924-e1928</ispartof><rights>Reprint &amp; Copyright © 2017 Association of Military Surgeons of the U.S.</rights><rights>Copyright Association of Military Surgeons of the United States Jul/Aug 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28810991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Crowell, Michael S</creatorcontrib><creatorcontrib>Mason, John S</creatorcontrib><creatorcontrib>Posner, Matthew A</creatorcontrib><creatorcontrib>Haley, Chad A</creatorcontrib><title>Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury. With a PCL tear, patients rarely describe an audible "pop" that is commonly reported in ACL injuries. On physical exam, a frequent finding in PCL tears is a loss of 10 to 20° of knee flexion. Although the most common clinical tests for PCL tears include the posterior drawer test, the posterior sag sign, and the quadriceps active test, there is a lack of high-quality diagnostic accuracy studies. Two cases of U.S. Military Academy Cadets who sustained PCL injuries while removing combat boots during military survival swim training are presented. The results of the clinical examination are accompanied by magnetic resonance imaging results and intraoperative arthroscopic images to highlight key findings. Both patients were evaluated and diagnosed with PCL injures within 10 days of their injuries. Each reported feeling/hearing a "pop," which is atypical in PCL tears. Both patients demonstrated a lack of active and passive knee flexion, which is a commonly reported impairment. One patient was managed nonsurgically with physical therapy and eventually returned to full duty without limitations 9 months after his injury. The other patient, who sustained a combined PCL-PLC injury, underwent a PCL reconstruction and PLC repair and reconstruction 8 weeks after his injury. He returned all training, with the exception of contact/collision sports, 9 months after surgery. Both patient's rehabilitation programs consisted of a progression of exercises to improve range of motion, muscle strength/endurance, motor control, and muscular power. Military and sports medicine professionals should be aware of the potential for PCL injury with this unusual, and previously unreported, mechanism of injury during survival swim training. Prompt diagnosis and appropriate treatment is essential to prevent long-term disability.</description><subject>Accuracy</subject><subject>Armed forces</subject><subject>Biomechanics</subject><subject>Education - statistics &amp; numerical data</subject><subject>Epidemiology</subject><subject>Humans</subject><subject>Joint and ligament injuries</subject><subject>Knee</subject><subject>Knee Injuries - complications</subject><subject>Knee Injuries - diagnosis</subject><subject>Knee Injuries - surgery</subject><subject>Male</subject><subject>Military Personnel - statistics &amp; numerical data</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Posterior Cruciate Ligament - injuries</subject><subject>Range of Motion, Articular - physiology</subject><subject>Skin &amp; tissue grafts</subject><subject>Sports injuries</subject><subject>Swimming - injuries</subject><subject>Swimming - physiology</subject><subject>Trauma</subject><subject>Young Adult</subject><issn>0026-4075</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkMtOwzAQRS0EoqXwAWyQJTZsDOM4cexl1Rao1AqkFsHOchKnuMoD7KSIvyd9wILVaDTnjmYOQpcUbuMAorv5dDafjMmYUE4AGAuPUJ9KBoRT9naM-gABJyHEUQ-deb8GoKEU9BT1AiEoSEn7aPlc-8Y4Wzs8cm1qdWPwzK50aaoGT6t166zxeOh9vZtl-NU273huC9to940XrdvYjS7w4suWeOm0rWy1OkcnuS68uTjUAXq5nyxHj2T29DAdDWckZUHYEKONiHUGXABEVBidZFkqZQ6hAcmjgApITGJSkQKPdBSEeRxx3fU5ZAnjjA3QzX7vh6s_W-MbVVqfmqLQlalbr6gMpJBCxHGHXv9D13Xrqu66jqKxCFgYbim6p1JXe-9Mrj6cLbtHFQW1Va72ytVYUa52yrvM1WFzm5Qm-0v8OmY_eSt9EQ</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Crowell, Michael S</creator><creator>Mason, John S</creator><creator>Posner, Matthew A</creator><creator>Haley, Chad A</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88F</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M1Q</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201707</creationdate><title>Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training</title><author>Crowell, Michael S ; Mason, John S ; Posner, Matthew A ; Haley, Chad A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-eae87ad06800518eabddc99f04e09652180bebec8c065a524f756aec8f0db3633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Accuracy</topic><topic>Armed forces</topic><topic>Biomechanics</topic><topic>Education - statistics &amp; numerical data</topic><topic>Epidemiology</topic><topic>Humans</topic><topic>Joint and ligament injuries</topic><topic>Knee</topic><topic>Knee Injuries - complications</topic><topic>Knee Injuries - diagnosis</topic><topic>Knee Injuries - surgery</topic><topic>Male</topic><topic>Military Personnel - statistics &amp; numerical data</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Posterior Cruciate Ligament - injuries</topic><topic>Range of Motion, Articular - physiology</topic><topic>Skin &amp; tissue grafts</topic><topic>Sports injuries</topic><topic>Swimming - injuries</topic><topic>Swimming - physiology</topic><topic>Trauma</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Crowell, Michael S</creatorcontrib><creatorcontrib>Mason, John S</creatorcontrib><creatorcontrib>Posner, Matthew A</creatorcontrib><creatorcontrib>Haley, Chad A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Military Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Military Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Crowell, Michael S</au><au>Mason, John S</au><au>Posner, Matthew A</au><au>Haley, Chad A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2017-07</date><risdate>2017</risdate><volume>182</volume><issue>7</issue><spage>e1924</spage><epage>e1928</epage><pages>e1924-e1928</pages><issn>0026-4075</issn><eissn>1930-613X</eissn><abstract>Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury. With a PCL tear, patients rarely describe an audible "pop" that is commonly reported in ACL injuries. On physical exam, a frequent finding in PCL tears is a loss of 10 to 20° of knee flexion. Although the most common clinical tests for PCL tears include the posterior drawer test, the posterior sag sign, and the quadriceps active test, there is a lack of high-quality diagnostic accuracy studies. Two cases of U.S. Military Academy Cadets who sustained PCL injuries while removing combat boots during military survival swim training are presented. The results of the clinical examination are accompanied by magnetic resonance imaging results and intraoperative arthroscopic images to highlight key findings. Both patients were evaluated and diagnosed with PCL injures within 10 days of their injuries. Each reported feeling/hearing a "pop," which is atypical in PCL tears. Both patients demonstrated a lack of active and passive knee flexion, which is a commonly reported impairment. One patient was managed nonsurgically with physical therapy and eventually returned to full duty without limitations 9 months after his injury. The other patient, who sustained a combined PCL-PLC injury, underwent a PCL reconstruction and PLC repair and reconstruction 8 weeks after his injury. He returned all training, with the exception of contact/collision sports, 9 months after surgery. Both patient's rehabilitation programs consisted of a progression of exercises to improve range of motion, muscle strength/endurance, motor control, and muscular power. Military and sports medicine professionals should be aware of the potential for PCL injury with this unusual, and previously unreported, mechanism of injury during survival swim training. Prompt diagnosis and appropriate treatment is essential to prevent long-term disability.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>28810991</pmid><doi>10.7205/MILMED-D-16-00334</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0026-4075
ispartof Military medicine, 2017-07, Vol.182 (7), p.e1924-e1928
issn 0026-4075
1930-613X
language eng
recordid cdi_proquest_miscellaneous_1929898877
source MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals
subjects Accuracy
Armed forces
Biomechanics
Education - statistics & numerical data
Epidemiology
Humans
Joint and ligament injuries
Knee
Knee Injuries - complications
Knee Injuries - diagnosis
Knee Injuries - surgery
Male
Military Personnel - statistics & numerical data
NMR
Nuclear magnetic resonance
Patients
Posterior Cruciate Ligament - injuries
Range of Motion, Articular - physiology
Skin & tissue grafts
Sports injuries
Swimming - injuries
Swimming - physiology
Trauma
Young Adult
title Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T18%3A05%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Posterior%20Cruciate%20Ligament%20Injuries%20Associated%20With%20Military%20Survival%20Swim%20Training&rft.jtitle=Military%20medicine&rft.au=Crowell,%20Michael%20S&rft.date=2017-07&rft.volume=182&rft.issue=7&rft.spage=e1924&rft.epage=e1928&rft.pages=e1924-e1928&rft.issn=0026-4075&rft.eissn=1930-613X&rft_id=info:doi/10.7205/MILMED-D-16-00334&rft_dat=%3Cproquest_cross%3E1917823447%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1917823447&rft_id=info:pmid/28810991&rfr_iscdi=true