Collateral Ligament

Gill CS, Sandell LJ, El-Zawawy HB, Wright RW. Effects of cigarette smoking on early medial collateral ligament healing in a mouse model. J Orthop Res 2006 24(12) 2141-9. 

Henninger HB, Maas SA, Underwood CJ, Whitaker RT, Weiss JA. Spatial distribution and orientation of dermatan sulfate in human medial collateral ligament. J Struct Biol 2007 158 33-45. 

Siegler, S., Block, J. and Schneck, C.D. (1988) The mechanical characteristics of the collateral ligaments of the human ankle joint. Foot Ankle, 8(5), 234-42. 

De Avila GA, O Connor BL, Visco DM, Sisk TD (1989) The mechanoreceptor innervation of the human fibular collateral ligament. J Anat 162 1-7... 

Woo SL, Orlando CA, Gomez MA, Frank CB, Akeson WH (1986) Tensile properties of the medial collateral ligament as a function of age. J Orthop Res 4 133-141... 

Matsumoto H, Suda Y, Otani T, NiM Y, Seedhom BB, Fujikawa K (2001) Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability. J Orthop Sci 6(l) 28-32... 

Furthermore, ACL tears are often associated with injuries to additional structures, such as the medial collateral ligament, meniscal tears, and Segond fracmres, which are capsular avulsion fractures of the lateral tibial plateau, found in 6-13 % of ACL ruptures [27] (Fig. 12.4C). 

McDougall JJ, Bray RC, Sharkey KA (1997) Morphological and immunohistochemical examination of nerves in normal and injured collateral ligaments of rat, rabbit, and human knee joints. Anat Rec 248 29-39... 

Shrive N, Chimich D, Marchuk L, Wilson J, Brant R, Frarrk C (1995) Soft-tissue flaws are associated with the material properties of the healing rabbit medial collateral ligament. J Orthop Res 13 923-929... 

Weiss JA, Woo SL, OhlandKJ, HoribeS, Newton PO (1991) Evaluation of anew injury model to study medial collateral ligament healing primary repair versus nonoperative treatment. J Orthop Res 9(4) 516-528... 

Woo SL, Inoue M, McGurk-Burleson E, Gomez MA (1987) Treatment of the medial collateral ligament injury. II structure and function of canine knees in response to differing treatment regimens. Am J Sports Med 15(l) 22-29... 

Bray RC, Leonard CA, SaioPT (2003) Correlation of healing capacity with vascular response in the anterior cruciate and medial collateral ligaments of the rabbit. J Orthop Res 21 1118-1123... 

Fig. 4.24. Extended field-of-view ultrasound of the medial collateral ligament in a young adult with a Pelligrini Stieda lesion arrow) following injury...

Fig. 4.25. Coronal proton density fat-saturated image demonstrating a heterogeneous swelling of the medial collateral ligament seen in Figure 4.21. Note that ultrasound demonstrates the calcification whereas MRI does not...

Tears of the ulnar collateral ligament of the thumb, referred to as gamekeeper s or skier s thumb are frequently encountered as a result of skiing injury. The torn ligament may become interposed beneath the adductor aponeurosis resulting in the... 

Stener lesion, which requires surgery as healing hy secondary intention will not occur. On ultrasound there is disruption of the ulnar collateral ligament with the Stener lesion appearing as a hypoechoic focal mass lying above the joint line (Ebrahim et al. 2006 O Callaghan et al. 1994). 

The largest of these joints, the tibiofemoral joint, obtains its stabihty from the conformity of its bony structures, the medial and lateral menisci, the medial and collateral ligaments, the anterior and posterior cruciate ligaments and the joint capsule. 

SH III - Usually the vertical fracture lies laterally with involvement of the lateral collateral ligament. 

The patient will present with a painful swollen knee, secondary to the haemarthrosis. The knee should be assessed for an associated collateral ligament inj ury, with instability on varus or valgus stressing. There may be a positive anterior draw test. 

Fractures of the head and neck of the fibula occur rarely in isolation and are more commonly associated with proximal tibial fractures, especially compression, bicondylar and subcondylar fractures. A spiral fracture of the proximal fibula is often associated with an ankle fracture, resulting from an external rotation force. These fractures are known as Maisonneuve fractures. Fibula head fractures can occur from direct impact, valgus stress (associated with a tibial condylar fracture), and varus injuries. Varus stresses can cause avulsion of the fibular styloid at the site of the biceps tendon and fibular (lateral) collateral ligament. Peroneal nerve injury is not uncommon with these injuries. Dislocation of the proximal fibula is often missed on the initial radiograph. 

Radiographs can identify associated avulsion injuries, such as Pelegrini-Stieda lesions (avulsion of the medial femoral condyle at the origin of the medial collateral ligament) and Segond lesion (avulsion fracture of the lateral tihial plateau). Segond fractures are associated with LCL, ACL and meniscal tears (Sferopoulos et al. 2006). 

The bony architecture of the elbow contributes to the stability of the joint, which is reinforced by the medial (ulnar) and lateral (radial) collateral ligaments, which provide most of the stability. 

Avulsion fractures of the medial epicondyle are seen between the ages of 9 and 15, after the apophysis becomes a separate ossification nucleus from the epiphysis of the distal humerus and before it fuses with the distal humerus. The medial epicondyle is a traction apophysis for the flexor group of forearm muscles, and also serves as an attachment for the ulnar collateral ligaments and the joint capsule. This injury accounts for up to 10% of elbow fractures. 

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