Treatment of Combined Anterior Cruciate-Posterior Cruciate Ligament-Medial-Lateral Side Knee Injuries

摘要

The multiple ligament injured knee is a complex problem in orthopedic surgery. These injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular status is essential for possible arterial or venous compromise. These complex injuries require a systematic approach to evaluation and treatment. Physical examination and imaging studies enable the surgeon to make a correct diagnosis and formulate a treatment plan.The incidence of posterior cruciate ligament injuries (PCL) is reported to range from 1% to 40% of acute knee injuries. The incidence is dependent on the patient population reported and is approximately 3% in the general population and 38% in reports from a regional trauma center.47'11 The incidence of PCL tears in acute knee injuries at the authors' regional trauma center is 38%, with more than half of these PCL injuries occurring in multiple trauma patients. Forty-six percent of these PCL injuries are combined anterior cruciate (ACL)-PCL tears, while 41% are PCL-posterolateral corner tears; only 3% of acute PCL injuries are isolated. This article describes the authors' approach to treatment and results in the multiple ligament injured knee.