关节镜辅助下空心拉力螺钉治疗Hoffa骨折的疗效分析

Curative Effect of Cannulated Screw Fixation for Treating Hoffa Fracture under Arthroscope

目的：探讨关节镜辅助下经皮复位、空心钉内固定治疗Hoffa骨折的手术方法及疗效。方法：回顾性分析2007年2月-2012年9月关节镜辅助下手术治疗且获得随访的13例Hoffa骨折患者的资料。男9例，女4例；年龄21～56岁，平均34．2岁。按照Letenneur分型：Ⅰ型7例，Ⅱ型3例，Ⅲ型3例。受伤至手术时间2～11d，平均5．3d．术中在关节镜辅助下行骨折复位，C臂机透视下确认骨折复位情况后，以空心拉力螺钉固定骨折块。结果：患者均获随访，随访时间7～85个月，平均25．6月，骨折均获骨性愈合。膝关节功能按Lysholm评分标准评定：优7例，良4例，中1例，差1例，优良率为84．6％．结论：关节镜辅助下空心拉力螺钉治疗Hoffa骨折具有手术创伤小、骨折复位确切、并发症少等优点，对术中伤情判断以及合并膝内损伤者具有明显诊治优势，是一种可行的微创治疗方法。

Objective ： To explore the curative effect of cannulated screw fixation under arthroscope in the treatment of Hoffa fracture. Methods： Retrospective 13 patients with Hoffa fracture, which were treated with arthroscopy-assisted surgery at our department and were followed up from February 2007 to September 2012. They were 9 males and 4 females, aged from 21 to 56 years （34.2 years averagely）. According to Letenneur classification, there were 7 cases of type Ⅰ , 3 cases of type Ⅱ , and 3 cases of type Ⅲ. The interval time from injury to operation was 2 to 11 days （5.3 days averagely）. The fracture was reduced and fixed with cannulated screws under arthroscope after confirming by C-arm X ray inspection. Results：They were all followed up for 7 to 85 months （25.6 months averagely）. The fractures were all healing. There were 7 patients in excellent results, 4 in good, one in fair, and one in poor according to Lysholm knee function score, and the overall rate of excellent and good was 84.6 %. Conclusion：Cannulated screw fixation under arthroscope is effective for treating Hoffa fracture. It is a feasible minimally invasive treatment method for its advantages of minimal soft tissue damage, fracture reduced precisely, fewer complications, and intraoperative judgment and diagnosis.