Nicandri Gregg T, Klineberg Eric O, Wahl Christopher J, Mills William J
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA 98105, USA.
J Orthop Trauma. 2008 May-Jun;22(5):317-24. doi: 10.1097/BOT.0b013e31817279d1.
To report clinical and functional outcomes following fixation of tibial posterior cruciate ligament (PCL) avulsion fractures through a modified open posterior approach when combined with a rehabilitation program emphasizing early range of motion.
Retrospective case series.
Level I trauma center.
From March 4, 2000 to May 8, 2003, there were 16 cases of PCL tibial avulsion injuries presented to our institution, with 10 patients available for follow up at 12 to 48 months (mean 28 months).
Fixation of tibial PCL avulsion fractures was with a lag screw and washer placed through a modified open posterior approach. Range of motion was begun on postoperative day 1.
Clinical stability, range of motion, gastrocnemius muscle strength, radiographic appearance, and each patient's overall health-related quality of life (using the musculoskeletal functional assessment tool) were evaluated at final follow up.
The average musculoskeletal functional assessment score was 14. (Musculoskeletal functional assessment scores range from 0-100, with higher scores indicating poorer function.) All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. Flexion difference greater than 10 degrees (P = 0.16), extension difference greater than 2 degrees (P = 0.38), and heel raise difference more than 8 repetitions (P = 0.23) were not demonstrated in comparison to the normal side.
Treatment of tibial PCL avulsion fractures, which includes fixation through a modified open posterior approach and early postoperative range of motion, results in healing of the fracture, good functional outcomes, stability to posterior draw testing, and does not lead to gastrocnemius weakness or significant range of motion deficits at 12 to 48 months postoperatively.
报告采用改良开放后入路固定胫骨后交叉韧带（PCL）撕脱骨折并结合强调早期活动范围的康复计划后的临床和功能结果。
回顾性病例系列。
一级创伤中心。
2000年3月4日至2003年5月8日，我院共收治16例PCL胫骨撕脱伤患者，其中10例患者在12至48个月（平均28个月）时接受随访。
通过改良开放后入路用拉力螺钉和垫圈固定胫骨PCL撕脱骨折。术后第1天开始活动范围训练。
在末次随访时评估临床稳定性、活动范围、腓肠肌力量、影像学表现以及每位患者的整体健康相关生活质量（使用肌肉骨骼功能评估工具）。
肌肉骨骼功能评估平均得分为14分。（肌肉骨骼功能评估得分范围为0 - 100分，得分越高表明功能越差。）所有患者骨折均愈合，在最近一次随访时膝关节临床稳定。与正常侧相比，未发现屈曲差异大于10度（P = 0.16）、伸直差异大于2度（P = 0.38）以及提踵差异超过8次重复（P = 0.23）。
胫骨PCL撕脱骨折的治疗包括通过改良开放后入路固定和术后早期活动范围训练，可使骨折愈合，获得良好的功能结果，后抽屉试验稳定，且在术后12至48个月不会导致腓肠肌无力或明显的活动范围受限。
