Malone A A, Dowd G S E, Saifuddin A
The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
Injury. 2006 Jun;37(6):485-501. doi: 10.1016/j.injury.2005.08.003. Epub 2005 Dec 19.
Injuries of the posterior cruciate ligament (PCL) and posterolateral corner (PLC) of the knee are less common than those of the anterior cruciate ligament (ACL) and their significance is often under-appreciated in the acute setting. Even when recognised, knowledge of the natural history and outcome of treatment has lagged behind that of the ACL and has led to confusion over the indications for operative treatment. Recent developments in the understanding of the anatomy and biomechanics of this area of the knee have led to improvements in management and a renewed interest in these potentially disabling injuries. The aim of this review is to bring the trauma generalist abreast of these recent developments and to improve diagnosis through a heightened index of suspicion and use of appropriate special investigations. The principles of management of both isolated and combined injuries to the PCL and PLC, in the acute and chronic settings, are described.
膝关节后交叉韧带(PCL)和后外侧角(PLC)损伤不如前交叉韧带(ACL)损伤常见,其重要性在急性损伤时常常未得到充分重视。即便损伤被识别,对其自然病程和治疗结果的了解仍落后于ACL损伤,这导致了手术治疗指征方面的困惑。近年来,对膝关节该区域解剖学和生物力学的认识取得进展,使得治疗有所改进,人们也重新关注这些可能导致功能障碍的损伤。本综述旨在让创伤科全科医生了解这些最新进展,并通过提高怀疑指数和采用适当的特殊检查来改进诊断。文中描述了急性和慢性情况下PCL和PLC孤立损伤及合并损伤的处理原则。