关节镜辅助下金属拉力螺钉配合可吸收螺钉治疗Hoffa骨折

Hoffa fractures fixed by metal lag screws and absorbable screws under arthroscope

目的评估在关节镜辅助下金属拉力螺钉配合可吸收螺钉治疗Hoffa骨折的临床疗效。方法对13例Hoffa骨折患者采取关节镜监视下撬搏复位,骨折复位满意后负重面采用可吸收螺钉埋头固定,非负重面采用金属拉力螺钉增强固定,同时Ⅰ期探查修复关节内其他损伤,术后行可调支具固定,早期进行非负重功能锻炼,定期随访并记录膝关节功能恢复程度。结果患者均获随访,时间8~24个月,平均随访13.6个月,术后切口均Ⅰ期愈合,内固定无松动、断裂,骨折骨性愈合,平均下地活动时间9.4周。按Hoffa骨折术后功能恢复评估标准综合评估膝关节功能恢复程度。优良12例,可l例,优良率为92.3%。结论关节镜辅助下金属拉力螺钉配合可吸收螺钉治疗Hoffa骨折,具有骨折复位满意、损伤小及固定牢固的优点,可Ⅰ期处理关节内其他损伤,明显降低膝关节僵硬程度,提高了患者生活质量。

Objective To evaluate the clinical efficacy of Hoffa fractures fixed by metal lag screws and absorbable screws under arthroscope. Methods 13 cases of Hoffa fracture were fixed by prizing reduction under arthroscopic surveillance. After satisfactory reduction, absorbable screw immersion was used to fix the load side,metal lag screw was used to reinforce the non-load side. At the same time, other injuries in the joint were repaired by I-stage. Adjustable brace fixation was performed after operation, and early non-load-bearing functional exercise was performed regularly. The degree of functional recovery of knee joint was recorded at follow up. Results All the patients were followed up for 8 to 24 months(average 13.6 months). All the incisions healed in one stage. There was no loosening or breakage of internal fixation and bone union occurred in the fracture. The average activity time is 9.4 weeks. According to the criteria of functional recovery after Hoffa fracture surgery, the functional recovery degree of knee joint was comprehensively assessed. 12 cases were excellent, and l cases was general curative effect,the excellent and good rate was 92.3%. Conclusions Under arthroscope, the using of metal lag screw combined with absorbable screw has the advantages of satisfactory reduction, minimal injury and firm fixation in the treatment of Hoffa fracture. It can be used to treat other intra-articular injuries in stage I, that can significantly reduce the stiffness of knee joint and improve the quality of life of patients.