钛质松质骨螺钉内固定置入治疗Hoffa骨折16例

Treatment of Hoffa fracture using titanium cancellous screw in 16 cases

2001-01/2005-06河南省洛阳正骨医院采用膝关节前正中切口髌旁入路松质骨螺钉固定治疗16例Hoffa骨折,术中直视下复位骨折,根据骨块大小及骨折线的走行方向,应用三四枚钛合金与骨折面垂直前后位固定。要求钉尾尽量位于股骨髁前侧关节面近端,如必须经过关节面,钉尾应沉于软骨下。螺纹应过骨折线,位于后髁骨块内。钉尖不能穿过后髁关节面。16例患者均获随访,随访时间6个月～3年,骨折均愈合,平均愈合时间3.7个月,无骨坏死发生。按Hohl膝关节功能评分标准评定疗效,优13例,良3例。结果提示Hoffa骨折只要得到及时的诊断,采用适宜的手术入路及良好的骨折复位、固定技术,完全可以避免或减少骨坏死、创伤性关节炎的发生,获得膝关节功能的良好恢复。

Sixteen cases with Hoffa fractures were chosen anterorredial approaches and received compressive cancellous screw treatment from January 2001 to June 2005. In the operation, 3 or 4 titanium cancellous screws were used to fix fracture surface according to the size of bone block and fracture line. Nail tail should lie at proximal end of articular surface at the front side of femoral condyle, and the nail should be sink to cartilage if pass the articular surface. Screw thread should pass through the fracture line to condyle. Especially, the tip of screw should be avoided posterior condylar surfaces. All the 16 cases were followed-up for 6 months to 3 years. All fractures were healed. The average time of union was 3.7 months. No avascular necrosis. According to the functional assessment of the knee of Hohl, the excellent results were 13 cases, and good were 3 cases. The result demonstrated that avascular necrosis and posttraumatic arthritis can be avoided or reduced completely due to in tJme dJagnosed, proper surgical approaches and accurate surgical techniques, and good function of knee joint can be obtained when Hoffa fractures happened.