Pandya Nirav K, Janik Luke, Chan Gilbert, Wells Lawrence
Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Clin Orthop Relat Res. 2008 Nov;466(11):2878-83. doi: 10.1007/s11999-008-0373-6. Epub 2008 Jul 22.
Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.
儿童后交叉韧带（PCL）止点处的骨软骨撕脱伤，尤其是来自胫骨的损伤，骨科医生并不常见。由于这些损伤较为罕见，因此需要仔细关注这些损伤所具有的特定体格检查和影像学表现，以便做出正确诊断。在骨骼未成熟的患者中，PCL的骨软骨撕脱伤在X线平片上可能会漏诊，因此磁共振成像对于正确诊断是必要的。有了这些知识，临床医生可以制定治疗计划，使患者恢复活动，同时避免因漏诊或治疗不当而导致的潜在并发症。我们报告了两例罕见的因胫骨止点骨软骨撕脱导致的PCL功能不全病例。两名患者随后均接受了切开复位及采用两种不同固定方法（生物可吸收锚钉与空心螺钉及垫圈）对撕脱伤进行内固定治疗，目前均已恢复全面的体育活动。
