Scott Chloe E H, Murray Alastair W
Department of Orthopaedics, Royal Hospital for Sick Children, Edinburgh, UK.
BMJ Case Rep. 2011 Nov 15;2011:bcr0920114803. doi: 10.1136/bcr.09.2011.4803.
The authors present the case of a 4-year-old boy who sustained an intrasubstance posterior cruciate ligament (PCL) tear whist trampolining. He was managed non-operatively with return to full function by 8 months. A high index of suspicion is required when assessing paediatric hyperflexion/extension injuries at the knee as ligamentous injury may occur without osteochondral fracture and may be missed on routine radiographs. Early MRI can identify such injuries in addition to osteochondral avulsions which are often amenable to acute internal fixation. In the case of paediatric intrasubstance PCL tears, it appears that non-operative management yields a good functional outcome in the short term in the skeletally immature.
作者报告了一例4岁男孩在蹦床时发生后交叉韧带实质内撕裂的病例。他接受了非手术治疗，8个月后恢复了全部功能。在评估儿童膝关节过度屈伸损伤时，需要高度怀疑，因为可能发生韧带损伤而无骨软骨骨折，且在常规X线片上可能漏诊。早期磁共振成像（MRI）除了能识别骨软骨撕脱外，还能识别此类损伤，而骨软骨撕脱通常适合急性内固定。对于儿童后交叉韧带实质内撕裂，在骨骼未成熟的情况下，非手术治疗似乎在短期内能产生良好的功能结果。
