Hayes C W, Brigido M K, Jamadar D A, Propeck T
Department of Radiology, University of Michigan Health System, Taubman Center, Rm 2910A, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0326,
Radiographics. 2000 Oct;20 Spec No:S121-34. doi: 10.1148/radiographics.20.suppl_1.g00oc21s121.
Complex knee injuries are common, often resulting from multiple forces: varus, valgus, hyperextension, hyperflexion, internal rotation, external rotation, anterior or posterior translation, and axial load. Certain combinations of forces are known to cause specific injury patterns. After a review of the literature, the authors developed a mechanism-based classification system based on patterns of bone marrow edema and ligament injury for complex knee injuries depicted at magnetic resonance imaging. The classification system takes into account knee position and forces and recognition of patterns of bone injury and complementary soft-tissue injury. Ten mechanism-based injury patterns were recognized: (a) pure hyperextension, (b) hyperextension with varus, (c) hyperextension with valgus, (d) pure valgus, (e) pure varus, (f) flexion with valgus and external rotation, (g) flexion with varus and internal rotation, (h) flexion with posterior tibial translation, (i) patellar dislocation (flexion, valgus, and internal rotation of femur on fixed tibia), and (j) direct trauma. Recognition of these patterns may help assess the full extent of knee injury, particularly at the posterolateral and posteromedial corners of the knee.
复杂膝关节损伤很常见，通常由多种力量导致：内翻、外翻、过度伸展、过度屈曲、内旋、外旋、前后移位以及轴向负荷。已知某些力量组合会导致特定的损伤模式。在回顾文献后，作者基于磁共振成像显示的复杂膝关节损伤的骨髓水肿和韧带损伤模式，开发了一种基于机制的分类系统。该分类系统考虑了膝关节位置、力量以及骨损伤模式和互补性软组织损伤的识别。识别出了十种基于机制的损伤模式：(a)单纯过度伸展，(b)过度伸展伴内翻，(c)过度伸展伴外翻，(d)单纯外翻，(e)单纯内翻，(f)屈曲伴外翻和外旋，(g)屈曲伴内翻和内旋，(h)屈曲伴胫骨后移，(i)髌骨脱位（股骨在固定胫骨上的屈曲、外翻和内旋），以及(j)直接创伤。识别这些模式可能有助于评估膝关节损伤的全貌，尤其是在膝关节的后外侧和后内侧角。
