摘要
目的探讨单纯Hoffa骨折的手术治疗方法,并观察其临床疗效。方法 2005年1月至2011年12月手术治疗单纯Hoffa骨折18例,男11例,女7例,年龄18～55岁,平均32.3岁。单髁骨折17例,其中外髁11例,内髁6例,双髁骨折1例。LetenneurⅠ型8例,Ⅱ型2例,Ⅲ型8例。手术入路采取前方髌旁内侧/外侧入路,应用2～3枚松质骨拉力螺钉由后向前固定,术后伸膝位石膏外固定2周。随访时间6～43个月,平均20.6个月。疗效评定参照Letenneur等的Hoffa骨折术后功能恢复评估标准进行评定。结果所有病例均骨性愈合,无膝关节感染、内固定松动、骨折块移位和骨折块缺血坏死等并发症。根据Letenneur等的Hoffa骨折术后功能恢复评估标准,优14例,可3例,差1例,优良率为77.8%。结论切开复位、拉力螺钉内固定和术后早期功能锻炼是治疗单纯Hoffa骨折的有效方法,临床疗效满意。
Objective To investigate the operative management of isolated Hoffa fractures and its clinical effect. Methods A total of 18 patients with 19 Hoffa fractures, including 17 single-condylar fractures （11 lateral con-dyles and 6 medial condyles） and one double-condylar fracture, were surgically treated from January 2005 to December 2011. There were 11 males and 7 females, with an mean age of 32.3 years （ranged from 18 to 55 years）. Of all the fractures, 8 were classified as Letenneur type Ⅰ fracture, 2 as type Ⅱ fracture and 9 as type Ⅲ fracture. An open approach with a medial or lateral parapatellar arthrotomy was used for reduction and 2 or 3 lag screws were inserted in a posterior-anterior direction for internal fixation. All the patients were well followed up, with an average period of 20.6 months （ranged from 6 to 43 months）. The clinical outcome was assessed according to the criteria proposed by Leten-neur. Results Union was achieved in all patients. There was no infection, fixation loosening, displacement or con-dyle ischemic necrosis. According to the criteria proposed by Letenneur, 14 patients had excellent-good outcome, 3 had fair outcome and 1 had poor outcome, with the excellent and good rate of 77.8%. Conclusion Open reduction and interfixation with lag screws followed by early mobilization is an effective treatment for Hoffa fracture.
出处
《海南医学》
CAS
2013年第12期1810-1812,共3页
Hainan Medical Journal
