螺钉结合抗滑钢板治疗股骨外侧髁Hoffa骨折

Internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fracture of the lateral femoral condyle

目的 ：探讨螺钉结合抗滑钢板内固定治疗股骨外侧髁Hoffa骨折的临床疗效。方法 ：2006年5月至2014年5月,采用螺钉加抗滑钢板内固定治疗股骨外侧髁Hoffa骨折患者17例,男13例,女4例;年龄27-59岁,平均32.5岁;均为新鲜闭合性骨折。骨折根据Letenneur分型：Ⅰ型8例,Ⅱ型4例,Ⅲ型5例。术后观察切口、骨折愈合时间,并采用Letenneur评估系统及HSS评分系统进行膝关节功能评价。结果：17例患者均获随访,时间10-24个月,平均14.6个月。手术切口均Ⅰ期愈合,未见内固定断裂、骨折畸形愈合及股骨髁坏死、下肢深静脉血栓发生。骨折愈合时间4-9个月,平均4.7个月。采用Letenneur评估系统进行评价,优10例,良4例,可3例;HSS总评分91.1±4.7,优15例,良2例。结论 ：螺钉结合抗滑钢板内固定治疗股骨外侧髁Hoffa骨折,固定坚强可靠,疗效优良,有利于骨折愈合及膝关节功能早期康复。

Objective：To explore the clinical effects of internal fixation with lag screws plus an anti sliding plate for the treatment of Hoffa fractures of the lateral femoral condyle. Methods：From May 2006 to May 2014,17 patients with Hoffa fractures of the lateral femoral condyle were treated with lag screws plus an anti sliding plate. There were 13 males and 4 females,ranging in age from 27 to 59 years,with a mean of 32.5 years. All the fractures were fresh and closed fractures. According to the Letenneur＇s classification,8 cases were typeⅠ,4 cases were typeⅡ,5 cases were type Ⅲ. All the patients had no injuries of the cruciate ligament and the another part of the knee. Operative incision and fracture healing time were observed,knee joint function was evaluated by Letenneur system and HSS standard. Results：The patients were followed up from 10 to 24 months with a mean of 14.6 months. All incisions achieved primary healing,and no internal fixation breakage,malunion,femoral candyle necrosis,deep vein thrombosis of lower extremity were found. Fracture healing time was from 4 to 9 months with an average of 4.7 months. According to Letenneur＇s functional assessment,10 patients got an excellent results,4 good,3 fair. Total HSS score was 91.1±4.7 on average,15 cases obtained excellent results,2 good. Conclusion：Internal fixation with lag screws and an anti sliding plate can result in excellent effects for Hoffa fractures of the lateral femoral condyle. The key to a successful surgery is an anatomic reduction and rigid fixation of the fracture.