White Eric A, Patel Dakshesh B, Matcuk George R, Forrester Deborah M, Lundquist Ryan B, Hatch George F Rick, Vangsness C Thomas, Gottsegen Christopher J
Department of Radiology, 1500 San Pablo Street, Second Floor Imaging, Los Angeles, CA, 90033, USA,
Emerg Radiol. 2013 Oct;20(5):429-40. doi: 10.1007/s10140-013-1121-0. Epub 2013 Mar 23.
Injury to the ACL or PCL of the knee most commonly involves a tear of the collagenous fibers of the ligament. Less frequently, a cruciate ligament injury involves an avulsion fracture at the origin or insertion of the ligament, usually from the insertion site on the tibial surface. Avulsion fractures of the cruciate ligaments are important, as they can be identified on radiographs, allowing a specific diagnosis. Although more common in children, when they occur in adults, they are more commonly associated with other injuries. The treatment of cruciate ligament avulsion fractures is different than the treatment of intrasubstance tears of the cruciate ligaments. These injuries can be treated conservatively or surgically with good outcomes. Recently arthroscopic fixation of these injuries with various fixation devices has become more frequent. Treatment largely depends on the type of fracture, particularly, the size, displacement, comminution, and orientation of the avulsed fracture fragment, in addition to the integrity of the attached cruciate ligament. This review article covers the anatomy and biomechanics of the cruciate ligaments, their injury patterns, and approach to management.
膝关节前交叉韧带（ACL）或后交叉韧带（PCL）损伤最常见的情况是韧带胶原纤维撕裂。较少见的情况是，交叉韧带损伤涉及韧带起点或止点处的撕脱骨折，通常发生在胫骨表面的止点部位。交叉韧带撕脱骨折很重要，因为在X线片上可以识别，从而做出明确诊断。虽然在儿童中更常见，但当发生在成人时，它们更常与其他损伤相关。交叉韧带撕脱骨折的治疗与交叉韧带实质内撕裂的治疗不同。这些损伤可以保守治疗或手术治疗，效果良好。近年来，使用各种固定装置对这些损伤进行关节镜下固定的情况越来越普遍。治疗很大程度上取决于骨折类型，特别是撕脱骨折块的大小、移位、粉碎程度和方向，以及附着的交叉韧带的完整性。这篇综述文章涵盖了交叉韧带的解剖学和生物力学、损伤模式以及处理方法。
