螺钉联合后路抗滑钢板固定治疗股骨髁冠状面骨折

Treatment of Hoffa fracture by posterior screws combined with anti-sliding plate

目的：探讨螺钉结合后路钢板手术治疗股骨髁冠状面骨折即Hoffa骨折的临床疗效。方法：回顾性分析2005年1月至2011年2月后方入路显露采用螺钉结合防滑钢板治疗的10例Hoffa骨折患者资料,男8例,女2例;年龄22~68岁,平均44.6岁。其中外髁骨折6例,内髁骨折4例,单侧双髁骨折1例。骨折按Letenneur分型：Ⅰ型4髁,Ⅱ型2髁,Ⅲ型4髁。分别采用后内侧或后外侧入路,直视下复位后先用空心螺钉或松质骨螺钉固定,然后重建钢板塑形后抗滑方式固定。结果：全部患者术后获平均12.4个月（6～24个月）随访。所有患者骨折均获骨性愈合,愈合时间为13~24周,平均18周,无感染、血管神经并发症,无骨折不愈合、内固定松动发生。按Letenneur的Hoffa骨折术后功能评估标准评定疗效：优8髁,良1髁,差1髁,优良率为90%。结论：后方入路螺钉联合钢板抗滑固定治疗Hoffa骨折,显露直观,固定坚强,无需外固定,可早期不负重活动,临床疗效满意。

Objective：To evaluate the clinical efficacy of Hoffa fracture fixed by screws combined with posterior anti-sliding plate.Methods：From January 2005 to February 2011,10 cases of Hoffa fracture including 8 males and 2 females,aged from 22 to 68 years,were treated by posterior screws combined with anti-sliding plate.According to Letenneur classification,4 cases were of type Ⅰ,2 of type Ⅱ,and 4 of type Ⅲ.All fractures were fixed by screws combined with anti-sliding plate through posterior approach.Results： All patients were followed up for average 12.4 weeks（6 to 24 weeks）.Fractures healed well after 13 to 24 weeks（average,18 weeks）.Incisions healed well,without infection and vascular-neural complications.Excellent-to-good rate was 90% according to Letenneur score.Conclusion： In treatment of Hoffa fracture,posterior screws combined with antisliding plate has advantages of good exposure,satisfactory reduction,strong fixation and satisfactory function recovery.