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使用螺钉固定治疗小儿孤立性后交叉韧带撕脱骨折:1例病例报告

Management of an isolated posterior cruciate ligament avulsion fracture in a pediatric patient using screw fixation: A case report.

作者信息

Ivansyah Muhammad Deryl, Kurniawan Aryadi, Parasmadhan Ragil

机构信息

Department of Orthopaedics and Traumatology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Indonesia.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110785. doi: 10.1016/j.ijscr.2024.110785. Epub 2024 Dec 26.

DOI:10.1016/j.ijscr.2024.110785
PMID:39753070
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11755080/
Abstract

INTRODUCTION

Isolated posterior cruciate ligament (PCL) avulsion fracture is rare in pediatric population. To our knowledge, there is no established guideline to treat this rare injury in children. This case highlights the diagnostic challenges and treatment strategies using screw fixation for such injuries, emphasizing the importance of timely intervention to prevent long-term complications.

CASE PRESENTATION

A 12-year-old girl presented with acute right knee pain following a fall. Imaging revealed an avulsion fracture of the posterior cruciate ligament. The patient underwent open reduction and internal fixation (ORIF) with two partially threaded cannulated screws. One year follow-up showed satisfactory post-operative outcomes.

DISCUSSION

This case features the diagnosis challenges and surgical treatment of a PCL injury in children. Surgical intervention is required to restore knee function, particularly in active pediatric patients. Challenges include the prompt diagnosis and the need for precise surgical techniques to minimize long-term sequelae.

CONCLUSION

Early diagnosis and appropriate surgical intervention are crucial for optimal outcomes in pediatric patients with Isolated PCL avulsion fractures. This case demonstrates the efficacy of ORIF in managing such injury.

CLINICAL IMPORTANCE

This report contributes to the limited existing literature on Isolated PCL avulsion fractures in pediatric patients and accentuates the need for awareness and early intervention to prevent future joint instability and degenerative changes.

摘要

引言

孤立性后交叉韧带(PCL)撕脱骨折在儿童群体中较为罕见。据我们所知,目前尚无针对儿童这种罕见损伤的既定治疗指南。本病例突出了对此类损伤采用螺钉固定的诊断挑战和治疗策略,强调了及时干预以预防长期并发症的重要性。

病例介绍

一名12岁女孩在跌倒后出现右膝急性疼痛。影像学检查显示后交叉韧带撕脱骨折。该患者接受了切开复位内固定术(ORIF),使用了两枚半螺纹空心螺钉。一年的随访显示术后结果令人满意。

讨论

本病例体现了儿童PCL损伤的诊断挑战和手术治疗。需要进行手术干预以恢复膝关节功能,尤其是对于活跃的儿童患者。挑战包括及时诊断以及需要精确的手术技术以尽量减少长期后遗症。

结论

早期诊断和适当的手术干预对于孤立性PCL撕脱骨折的儿童患者获得最佳结果至关重要。本病例证明了ORIF治疗此类损伤的有效性。

临床意义

本报告为关于儿童孤立性PCL撕脱骨折的现有有限文献做出了贡献,并强调了提高认识和早期干预以预防未来关节不稳定和退行性改变的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/fc3a2a148885/gr6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/fc3a2a148885/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/05f7b155c101/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/9fc1033b59a7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/1a44de121ce4/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/48aab6ea3bf8/gr4.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfce/11755080/fc3a2a148885/gr6.jpg

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本文引用的文献

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The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines.SCARE 2023 指南:更新共识外科病例报告(SCARE)指南。
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Treatment of tibia avulsion fracture of posterior cruciate ligament with total arthroscopic internal fixation with adjustable double loop plate: A retrospective cohort study.关节镜下可调双环板内固定治疗后交叉韧带胫骨止点撕脱骨折:回顾性队列研究。
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Posterior cruciate ligament lesions are mainly present as combined lesions even in sports injuries.后交叉韧带损伤主要表现为合并损伤,即使在运动损伤中也是如此。
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