【摘要】 [目的]介绍超声引导经皮复位空心钉固定后交叉韧带（posterior cruciate ligament, PCL）胫骨撕脱骨折的手术技术和初步临床效果。[方法]对21例MeyersⅡ型PCL胫骨止点撕脱骨折患者行此手术治疗。患者麻醉后取俯卧位，屈膝5°～10°，C形臂X线机透视PCL胫骨止点撕脱骨折做腘窝体表标记，在标记内侧作长1 cm横行切口，超声定位腘窝血管、神经，切口内置入导向套管，在超声引导下沿血管、神经内侧向前推进至PCL撕脱骨块后缘，按压导向套管复位骨块，沿导向套管置入2枚克氏针，分别留作临时固定和导针用，移除导向套管，空心钻钻孔，置入空心钉固定，超声证实血管、神经完好后，缝合切口。[结果]所有患者均顺利完成手术，无腘窝血管、神经损伤等并发症。完全负重活动时间平均（61.6±2.8） d。随访6～12个月，末次随访时，Lysholm评分由术前的（30.1±7.6）分显著增加至（92.1±3.4）分（P<0.001），所有患者膝关节稳定，后抽屉试验阴性，伸屈活动正常。[结论]超声引导经皮复位空心钉固定PCL胫骨撕脱骨折技术可行，具有安全、创伤小的优点，初步临床效果满意。更多还原

【Abstract】 [Objective] To introduce the surgical technique and the preliminary clinical outcome of ultrasound-guided percutaneous reduction and cannulated screw fixation of posterior cruciate ligament(PCL) tibial avulsion fracture. [Methods] A total of 21 patients received this surgical procedure for Meyers type Ⅱ PCL tibial avulsion fracture. After anesthesia, the patient was placed in prone position with knee flexion from 5° to 10°. Under fluoroscopy, the PCL tibial avulsion fracture position was marked on the popliteal fossa surface, and then a 1 cm transverse incision was made on the mark. As the popliteal blood vessels and nerves were located by ultrasound, a guiding cannula was placed through the incision, and then advanced along the medial side of the blood vessels and nerves to the posterior edge of the avulsed PCL bone fragment. The guide cannula was pressed to reduce the bone fragment, and two Kirschner wires were placed over the guide cannula, one used for temporary fixation and another used as guide pin, respectively. After the guide cannula removed, drill a hole with cannulated drill bit, and then fix the bone fragment with a cannulated screw. After ultrasound confirmed the blood vessels and nerves intact, the incision was sutured. [Results] All patients had operation performed successfully without popliteal neurovascular injury and other complications. The patients regained full weight-bearing activity in a mean of(61.6±2.8) days, with Lysholm score significantly increased from(30.1±7.6) preoperatively to(92.1±3.4) at the last follow-up(P<0.001). All of them had stable knee, with negative posterior drawer test, and normal extension-flexion range of motion at the latest follow-up. [Conclusion] This ultrasound-guided percutaneous reduction and cannulated screw fixation of posterior cruciate ligament(PCL) tibial avulsion fracture is feasible in technique, with advantages of high safety and less trauma, and achieves satisfactory preliminary clinical consequece.更多还原