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后交叉韧带损伤:最常见损伤的特征及关联

Posterior cruciate ligament injury: characteristics and associations of most frequent injuries.

作者信息

Caldas Marco Túlio Lopes, Braga Gilberto Ferreira, Mendes Samuel Lopes, da Silveira Juliano Martins, Kopke Robson Massi

机构信息

Orthopedist and Traumatologist; Head of the Medical Residence Service of Hospital Maria Amélia Lins, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG); Member of the Knee Group of Hospital Maria Amélia Lins, FHEMIG, Belo Horizonte, MG, Brazil.

Preceptor of Medical Residence in Orthopedics and Traumatology, Hospital Maria Amélia Lins, FHEMIG, Belo Horizonte, MG, Brazil.

出版信息

Rev Bras Ortop. 2013 Oct 22;48(5):427-431. doi: 10.1016/j.rboe.2012.09.010. eCollection 2013 Sep-Oct.

Abstract

OBJECTIVE

To investigate the prevalence and combinations of PCL injuries and their correlations with the mechanism, the occurrence of evident dislocation and associated fracture.

METHOD

A retrospective study of 85 lesions of PCL operated between 2003 and 2010. Diagnosis by physical examination and dynamic radiography, compared with surgical findings.

RESULTS

Injuries involving the PCL were more prevalent in men (78.8%) with a mean age of 33 years. The main cause was traffic accidents (73.80%), and (49.4%) motorcycle. Isolated PCL injury occurred in (15.3%) cases, and combined (84.7%). Among the isolated lesions, bone avulsions were nine (10.6%). The most associated PCL injuries were the ACL (48.2%), followed by LCL PCL/PLC (22.4%). Fractures were more associated with combining PCL + LCL/PLC injuries and did not appear in the PCL + MCL/PMC. Complications beyond fractures: peripheral nerve injury (4.8%) and vascular (1.2%). Evident dislocation in primary care (16.7%) was more prevalent in combined ACL + PCL + MCL/PMC (44.4%). Half the patients were operated during the acute phase. There was a statistically significant difference ( < 0.05) comparing each combination of ligament injuries with the presence of fracture, dislocation or clear mechanism of injury.

CONCLUSION

Surgical treatment of PCL injuries in a center for orthopedic trauma care was mostly multiligament and mainly involving the ACL. A significant association was seen between the type of injury with mechanism of injury, presentation of the knee, if dislocated or reduced, and the presence of associated fracture.

摘要

目的

探讨后交叉韧带(PCL)损伤的发生率、合并情况及其与损伤机制、明显脱位及相关骨折发生情况的相关性。

方法

对2003年至2010年间接受手术治疗的85例PCL损伤病例进行回顾性研究。通过体格检查和动态X线摄影进行诊断,并与手术结果进行比较。

结果

PCL损伤在男性中更为常见(78.8%),平均年龄为33岁。主要原因是交通事故(73.80%),其中骑摩托车事故占(49.4%)。孤立性PCL损伤发生在(15.3%)的病例中,合并损伤占(84.7%)。在孤立性损伤中,骨撕脱有9例(10.6%)。最常合并的PCL损伤是前交叉韧带(ACL,48.2%),其次是外侧副韧带/后外侧角(LCL/PLC,22.4%)。骨折更多与PCL + LCL/PLC合并损伤相关,而在PCL + 内侧副韧带/后内侧角(MCL/PMC)损伤中未出现。骨折以外的并发症:周围神经损伤(4.8%)和血管损伤(1.2%)。初诊时明显脱位(16.7%)在合并ACL + PCL + MCL/PMC损伤中更为常见(44.4%)。半数患者在急性期接受手术。比较每种韧带损伤组合与骨折、脱位或明确损伤机制的存在情况,差异有统计学意义(<0.05)。

结论

在创伤骨科中心,PCL损伤的手术治疗大多为多韧带损伤,主要涉及ACL。损伤类型与损伤机制、膝关节表现(是否脱位或复位)以及相关骨折的存在之间存在显著关联。

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