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使用空心松质骨螺钉治疗孤立性Hoffa骨折的功能结果

Functional Outcome of Isolated Hoffa Fractures Treated with Cannulated Cancellous Screw.

作者信息

Singh R, Singh R B, Mahendra M

机构信息

Department of Orthopaedics, Sardar Vallabhbhai Patel Hospital, New Delhi, India.

出版信息

Malays Orthop J. 2017 Jul;11(2):20-24. doi: 10.5704/MOJ.1707.016.

Abstract

Isolated Hoffa fracture is an infrequent injury and little research has been done on this subject. The purpose of this study was to evaluate the functional outcome and complications of surgically managed Hoffa fractures with cannulated cancellous screw. Between 2011 and 2014, eight isolated Hoffa fractures in seven adult patients with mean age 39.8±11.9 years (range 25-60 years) were managed with cannulated cancellous screw of 6.5mm diameter applied in anterior to posterior direction using swashbuckler and medial parapatellar approach for lateral and medial Hoffa fractures respectively. All patients were evaluated using knee evaluation score after two years or longer. Mean follow up was 28±3.8 months (range 24-36 months). All fractures in the eight patients healed clinicoradiologically by the 16th week with excellent result in 87.5% cases and good in 12.5% cases. By the end of union, the range of motion (ROM) of the knee was 0° to 110° except in two patients. One patient had ROM 10°-100° and other had 15°-90°. Mean knee evaluation score was 87.5±10.4. There was no incidence of non-union, infection or avascular changes in the patients or loss of reduction till final follow up. Open reduction and fixation with two 6.5 mm cannulated cancellous screws with early mobilization yielded good functional outcome in isolated Hoffa fractures.

摘要

孤立性Hoffa骨折是一种罕见的损伤,对此主题的研究较少。本研究的目的是评估采用空心松质骨螺钉手术治疗Hoffa骨折的功能结果和并发症。2011年至2014年期间,对7例成年患者(平均年龄39.8±11.9岁,范围25 - 60岁)的8例孤立性Hoffa骨折进行了治疗,分别采用“海盗”入路和内侧髌旁入路,对外侧和内侧Hoffa骨折从前向后方向应用直径6.5mm的空心松质骨螺钉。所有患者在两年或更长时间后使用膝关节评估评分进行评估。平均随访时间为28±3.8个月(范围24 - 36个月)。8例患者的所有骨折在第16周时临床影像学愈合,87.5%的病例结果优秀,12.5%的病例结果良好。到骨折愈合结束时,除2例患者外,膝关节的活动范围(ROM)为0°至110°。1例患者的ROM为10° - 100°,另1例为15° - 90°。平均膝关节评估评分为87.5±10.4。直至最终随访,患者未发生骨不连、感染或缺血性改变,也没有复位丢失的情况。采用两枚6.5mm空心松质骨螺钉切开复位内固定并早期活动,在孤立性Hoffa骨折中取得了良好的功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbac/5630046/c69c07258751/moj-11-020-f1.jpg

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