后交叉韧带胫骨止点撕脱骨折

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,LOGO,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,后交叉韧带胫骨止点撕脱骨折,病历资料：,患者：刘某,性别：男 年龄：,40,岁,主诉,：,摔伤致右膝肿痛、活动受限,1,天。,现病史,：,患者,1,天前骑自行车时不慎摔倒，右膝下撞击硬物，伤后即感右膝肿胀、疼痛、行走负重困难。伤后行右膝关节,X,线及,MRI,提示：右侧胫骨髁间棘骨折，遂入住院治疗。,专科情况,：,右膝关节稍肿胀，右膝下可见少量皮肤擦伤，局部无明显压痛及叩击痛，右膝关节内外翻试验阴性，抽屉试验阴性，右小腿无肿胀，右足趾血运、感觉、运动正常。,影像资料,1,：,2024/9/10,影像资料,2,：,2024/9/10,影像资料,3,：,2024/9/10,入院诊断：,右膝关节后交叉韧带胫骨止点撕脱骨折,诊疗计划：,给予制动、消肿治疗，完善相关检查；,行,右膝关节后交叉韧带胫骨止点撕脱骨折切开复位内固定术；,切开设计：,半膜肌与腓肠肌内侧头间隙,2024/9/10,术后复查影像：,2024/9/10,术后切口外观照：,2024/9/10,概述,:,起止点,：,股骨髁间窝的内髁壁,-,胫骨平台髁间窝后下方约,1cm,处；,主要功能,：,限制胫骨的后移；,膝关节过伸、旋转及膝关节侧方活动；,特点,：,PCL,较,ACL,粗壮；,胫骨附着点面积大，受力牵拉明显大于股骨附着点；,胫前伤,过伸伤,过屈伤,屈曲内外翻伤,高能量,-PCL,实质断裂（合并损伤）,低能量,-PCL,止点撕脱骨折,损伤机制：,2024/9/10,分型：,Meyers 和 McKeever 分型型：,型：无移位性骨折,-,保守治疗,；,型：呈合页状，一侧相连,-,保守,or,手术,；,型：为完全移位性骨折,-,手术,型：为分层骨折，完全移位并翻转,-,手术,；,2024/9/10,手术方法：,关节镜,：,扎实的理论功底和熟练关节镜操作技术；,切开复位内固定,：,传统,S,切口,倒,L,切口,腘窝正中切口,内侧纵行小切口,2024/9/10,术后康复锻炼：,支具,固定于伸直位，防止膝关节后侧挛缩；,2.股四头肌和踝泵锻炼：,3.,术后2周开始膝关节屈伸练习，佩戴支具部分负重活动，术后8周开始完全负重拆除,支具,。,具体的康复过程应结合病情、术中情况、术式及内固定物的不同具体调整。,2024/9/10,总结：,1.,了解受伤机制，完善检查，排除有无合并损伤,；,2.,选择熟悉的治疗方式；,3.,可靠的固定；,4.,后期功能康复锻炼；,2024/9/10,谢 谢！,Thank You !,不尽之处，恳请指正！,