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Orthopaedic Surgery
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Answer 5
- Combined PCL and posterolateral corner injury.
The patients physical examination demonstrated a 3+ posterior drawer and external rotation asymmetry at both 30 and 90 degrees of flexion. This is characteristic of a combined PCL and posterolateral corner injury. The apparent increased excursion of the tibia is caused by a posterior starting point and is a false-positive result. The key physical examination for a PCL injury is the posterior drawer test. A 3+ grade implies that the proximal tibia can be displaced behind the medial femoral condyle. Grade 3 PCL injuries are frequently associated with combined posterolateral corner injuries. It is essential to correct both deficiencies at the time of surgery, which ideally should be performed within the first 2 to 3 weeks following the injury.
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