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霍法骨折合并膝关节旋转脱位:一例新病例报告

Hoffa fracture combined with rotational dislocation of the knee joint: A novel case report.

作者信息

Huang Guanning, Zhang Minglei, Zhang Youjia, Wang Xukai, Zhang Mingran, Liu Guangyao

机构信息

Department of Orthopedics.

Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, P.R. China.

出版信息

Medicine (Baltimore). 2021 Apr 9;100(14):e25253. doi: 10.1097/MD.0000000000025253.

Abstract

RATIONALE

Hoffa fracture is a rare fracture confined to the coronal-plane involving femoral condyles. This occurs simultaneously with rotational dislocation of the knee joint is extremely rare. Up to now, there is no valid recommendation for the treatment of the Hoffa fracture.

PATIENT CONCERNS

A 50-year-old female patient broke her knee joint while skiing, experiencing severe pain in the right knee, which was swollen. She presented limited function of the knee and movement upon arrival in the emergency room.

DIAGNOSIS

Comminuted Hoffa fracture in the right knee associated with rotational dislocation in the knee joint.

INTERVENTIONS

We treated the dislocated knee joint through manual reduction initially. During the operation, we used posterolateral approach to expose the fracture fragments, thereafter using headless compression screws and a buttress plate to provide sufficient stability for the fracture. Early postoperative rehabilitation was encouraged.

OUTCOMES

The patient finally achieved fracture healing three months after operation. In addition, she achieved 0-130° range of function of the knee after four months post-operation, and the patient obtained a satisfactory prognosis after our treatment.

LESSONS

By using appropriate surgical approach to obtain enough exposure, headless compression screws and the buttress plate provided adequate stability during early active rehabilitation, which resulted in satisfactory results in the treatment of the injury. We reviewed literatures regarding the treatment of Hoffa fracture to demonstrate that our treatment was effective.

摘要

原理

Hoffa骨折是一种局限于冠状面累及股骨髁的罕见骨折。同时伴有膝关节旋转脱位的情况极为罕见。到目前为止,对于Hoffa骨折的治疗尚无有效的推荐方案。

患者情况

一名50岁女性患者在滑雪时膝关节受伤,右膝剧痛且肿胀。到达急诊室时,她的膝关节功能受限且活动困难。

诊断

右膝粉碎性Hoffa骨折伴膝关节旋转脱位。

干预措施

我们首先通过手法复位治疗脱位的膝关节。手术中,采用后外侧入路暴露骨折碎片,然后使用无头加压螺钉和支撑钢板为骨折提供足够的稳定性。鼓励术后早期康复。

结果

患者术后三个月最终实现骨折愈合。此外,术后四个月膝关节功能范围达到0-130°,经我们治疗后患者获得了满意的预后。

经验教训

通过采用合适的手术入路获得足够的暴露,无头加压螺钉和支撑钢板在早期积极康复过程中提供了足够的稳定性,从而在该损伤的治疗中取得了满意的效果。我们查阅了关于Hoffa骨折治疗的文献以证明我们的治疗是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65eb/8036118/ffa1483286f2/medi-100-e25253-g001.jpg

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