tailieunhanh - Chấn thương dây chằng

Chấn thương dây chằng sau cruciate (PCL) đại diện cho 3% đến 20% của tất cả các chấn thương ligamentous đầu gối, nhưng việc chẩn đoán thường được bỏ qua đánh giá ban đầu. Sự nhạy bén chẩn đoán là tăng kiến thức về cơ chế sinh học và nghiên cứu chọn lọc cắt dây chằng đầu gối. | Isolated and Combined Posterior Cruciate Ligament Injuries Daniel M. Veltri MD and Russell F. Warren MD Abstract Posterior cruciate ligament PCL injuries represent 3 to 20 of all knee ligamentous injuries but the diagnosis often is missed at initial evaluation. Diagnostic acumen is increased by knowledge of knee biomechanics and selective ligament-cutting studies. The examiner must differentiate the isolated PCL injury from combined ligamentous injury to determine appropriate treatment. Isolated acute PCL tears with less than 10 mm of posterior laxity at 90 degrees of flexion should be treated with an aggressive rehabilitative program. This amount of laxity is found in the majority of isolated acute PCL tears. Isolated acute PCL tears with more than 10 to 15 mm of posterior laxity and PCL tears with combined ligamentous injuries should be reconstructed. Large PCL bony avulsions should be fixed internally. Small PCL bony avulsions with more than 10 mm of posterior laxity should be reconstructed. Chronic PCL injuries initially should be treated with an aggressive rehabilitation program. If such a program is not successful in a patient with more than 10 to 15 mm of posterior laxity and no significant radiographic evidence of degenerative changes the PCL should be reconstructed. J Am Acad Orthop Surg 1993 1 67-75 Injury to the posterior cruciate ligament PCL is thought to account for 3 to 20 of all knee ligament 2 The true incidence of PCL injuries remains unknown because many isolated PCL injuries may be undetected. Parolie and Bergfeld3 noted a 2 PCL injury rate among asymptomatic college football players invited to the National Football League predraft examination. Accurate diagnosis of the PCL injury is the first step in determining appropriate management. The ability to differentiate an isolated from a combined ligamentous injury is aided by a knowledge of knee biomechanics obtained with the use of selective ligament-cutting It is also .