第一页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLivesSmith&Nephew:HelpPeopleRegainTheirLives第二页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(sǔnshāng)3第三页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(sǔnshāng)4第四页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLivesPCL概况(gàikuàng)PCL起自:髁间凹部位的股骨内髁(7-12点/12-5点),38mmPCL止点:胫骨近端后侧面、胫骨内外髁后缘当中凹陷处,距离胫骨后方的关节面约1CM损伤机制:一般由于过度伸膝或者屈膝时前方的暴力(bàolì)引起很少产生不稳定症状,但会有上下楼梯、上下坡及下蹲时乏力陈旧性损伤患者已膝关节慢性疼痛为主诉5第五页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(gàikuàng)PCL(在髁间凹内侧呈倒水滴状)可分为两束:AL(前外束:屈膝紧张(jǐnzhāng)),PM(后内束),强度比ACL高6第六页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(yùhé)PCL近侧部分是为关节内结构远侧部分为关节外结构靠近股骨的1/3被滑膜从四周包绕中、远1/3的前远侧面(腹侧)被滑膜覆盖,近、后侧面则与后纵隔连接,无滑膜覆盖PCL的营养主要来自后纵隔及关节囊的血供PCL中、远1/3实质部断裂后有相当强的自愈能力对于急性PCL部分损伤(sǔnshāng)和中、远部断裂可保守治疗。7第七页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(duànliè)PCL断裂分类II度:胫骨后移度:胫骨后移<5mm<5mm;;8第八页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(zhònɡjiàn)经胫骨隧道技术(transtibialtechnique)9第九页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives(zhònɡjiàn)前外束的股骨止点和后内束的胫骨止点,从功能(gōngnéng)上主要是PCL的前外束。10第十页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLivesPCL重建(zhònɡjiàn)技术注意要点取移植物的技术胫骨(jìnggǔ)隧道准备股骨PCL定位股骨隧道准备第十一页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives①PCL重建(zhònjiàn)ɡ_所需器械第十二页,共四十一页。Smith&Nephew:HelpPeopleRegainTheirLives所需器械-所需器械-AcufexDirectorAcufexDirector瞄准系统瞄准系统在重建手术中提供精确的导向适应不同患者、不同医师的各种需要人体工程学设计使操...