A Case Report on an MCL and LCL Sprain

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A Case Report on an MCL and LCL Sprain

• By Lindsey Allerton

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General Anatomy of the Knee

• MCL
• primary medial stabilizer against valgus force
• Origin medial epicondyle inferior to adductor
  tubercle
• Inserts 6-10 cm below the tibial plateau
• LCL
• protects against a varus force
• Origin lateral femoral epicondyle
• Inserts Fibular head

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Background

• 15 year old female soccer player
• No previous injury
• Exact mechanism to L knee unknown
• (-) Lachmans, posterior/anterior drawers

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Background contd

• Valgus/Varus stress tests () for pain
• Significant swelling, ecchymosis, discoloration
• Initial diagnosis Pre-patella bursitis
• Saw a physician and received an MRI

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Differential Diagnosis

• Patellar/Tibial fracture
• MCL tear/sprain
• LCL tear/sprain

• Pre-Patella Bursitis
• Contusion
• ACL/PCL tear

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Diagnosis

• MCL sprain
• LCL sprain

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Treatment

• Day of Injury
• Compression wrap and donut pad
• RICE
• 2 Days After
• Knee immobilizer
• Crutches
• Quad sets, SLR

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Treatment

• After Seeing Physician
• Hinged brace
• Crutches
• Current Rehab
• Quad sets, SLR w/weight
• Balancing
• Wall squats
• RICE

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Uniqueness

• Injury to both MCL and LCL alone is rare
• Not well studied
• Presented as Pre-patella bursitis
• Non-operative rehabilitation

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Conclusion

• She is continuing rehab and wearing the hinged
  brace
• There is still significant swelling
• Expected to have a full recovery
• Return to play based on progress through rehab
  and doctors discretion
• Rare case and more studies need to be done