空心加压螺钉结合支撑钢板治疗Hoffa骨折

Effect of cannulated screw combined with support plate in the treatment of Hoffa fracture

目的：评价空心加压螺钉结合支撑钢板内固定治疗Hoffa骨折的临床效果。方法：对9例Hoffa骨折患者采取切开复位、前后空心加压螺钉结合支撑钢板内固定治疗。按Letenneur分型Ⅰ型5例,Ⅱ型2例,Ⅲ型2例。2例合并髁上骨折,3例合并髁上、髁间骨折。并根据Hoffa骨折术后功能恢复评估标准综合评估膝关节功能。结果：所有患者均获随访,时间3~24个月,术后切口均一期愈合,无早期并发症。术后内固定无松动、断裂,无骨折不愈合及股骨髁缺血性坏死发生。愈合时间8~12周。Hoffa骨折术后功能恢复评估：优7例,良2例。结论：空心加压螺钉结合支撑钢板治疗Hoffa骨折内固定可靠,可早期进行功能锻炼,治疗效果满意。

Objective： To investigate the clinical effects of cannulated screw combined with support plate in the treatment of Hoffa fracture. Methods： Nine patients with Hoffa fractures were treated with open reduction,anterior-to-posterior cannulated screw combined with support plate fixation. Type Ⅰ in 5 cases,type Ⅱ in 2 cases and type Ⅲ in 2 cases were observed in 5 males and 1 female according to Letenneur classification. Supracondylar fracture in 2 cases and supracondylar complicated with intercondylar fracture in 3cases were found. The postoperative function of knee joint was evaluated according to the Letenneur knee function evaluation system.Results： All patients were followed up for 3 to 24 months. All incisions were primary healing without early complication. The interfixation loosing and rupture,fracture nonunion and avascular necrosis of femoral condyle were not found after operation. The time fracture healing was 8 to 12 weeks. The functional recovery of 7 cases and 2 cases were excellent and good according to Hoffa evaluation system,respectively. Conclusions： The theraputic effects of cannulated screw combined with support plate on Hoffa fracture are reliable and good,the patients can do early functional exercise.