National Physical Therapy Examination (NPTE) Practice Exam

What is the status of healing tissue in a patient with a grade II injury to the right medial collateral ligament of the elbow, three weeks post-injury?

1. Well organized and gaining in tensile strength

2. Well organized and capable of withstanding high tensile forces

3. Disorganized but able to withstand high tensile forces

4. Disorganized and unable to withstand high tensile forces

The correct answer is: Disorganized and unable to withstand high tensile forces

A grade II injury to the medial collateral ligament involves a partial tear, which typically results in some loss of structural integrity while still allowing for some function of the ligament. At three weeks post-injury, the healing process is still underway. During the early phase of healing, particularly within the first few weeks, the tissue is still in the inflammatory and proliferative stages. At this point, the collagen fibers that are forming in the healing tissue are likely to be disorganized. This disorganization occurs because the body is laying down new collagen in a relatively random fashion as it responds to the initial injury. Consequently, this tissue lacks the proper orientation and alignment that is needed to handle high tensile forces effectively. Furthermore, the tensile strength of the healing ligament is also compromised. While some collagen synthesis is happening and the tissue is gaining strength, it is not yet robust enough to withstand significant stress or strain. Therefore, the status of the tissue three weeks post-injury in a grade II injury to the medial collateral ligament would indeed be characterized as disorganized and unable to withstand high tensile forces, reflecting the ongoing healing process and the incomplete maturation of the tissue.