Zhao Li-lai, Tong Pei-jian, Xiao Lu-wei
Zhongguo Gu Shang. 2016 Mar;29(3):266-9.
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.
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 type I, 4 cases were type II, 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.
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.
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.
探讨拉力螺钉联合防滑钢板内固定治疗股骨外侧髁Hoffa骨折的临床疗效。
2006年5月至2014年5月,对17例股骨外侧髁Hoffa骨折患者采用拉力螺钉联合防滑钢板内固定治疗。其中男13例,女4例;年龄27~59岁,平均32.5岁。均为新鲜闭合性骨折。按Letenneur分型:Ⅰ型8例,Ⅱ型4例,Ⅲ型5例。所有患者均无交叉韧带及膝关节其他部位损伤。观察手术切口及骨折愈合时间,采用Letenneur系统和HSS标准评估膝关节功能。
患者随访10~24个月,平均14.6个月。所有切口均一期愈合,未发现内固定断裂、骨不连、股骨髁坏死及下肢深静脉血栓形成。骨折愈合时间4~9个月,平均4.7个月。按Letenneur功能评定:优10例,良4例,可3例。HSS总分平均91.1±4.7分,优15例,良2例。
拉力螺钉联合防滑钢板内固定治疗股骨外侧髁Hoffa骨折疗效优良。手术成功的关键是骨折的解剖复位和坚强固定。