The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Orthop Surg. 2022 Mar;14(3):492-500. doi: 10.1111/os.13201. Epub 2022 Jan 30.
To determine the efficacy of distal femur condyle locking plate (DFCLP) alone or in combination with cannulated screws for Hoffa fractures.
In this study, between May 2014 and February 2019, 13 patients between 26 and 64 years with isolated Hoffa fractures were enrolled during the study period and retrospectively analyzed. All patients underwent open reduction and internal fixation by DFCLP alone or in combination with cannulated screws followed by early active rehabilitation postoperatively. The primary outcome was evaluated using range of movement (ROM), Knee Society Score (KSS), International Knee Documentation Committee (IKDC) scoring system, and the fracture healing time of the patients during the 24-month follow-up period. Postoperative complications were also used to assess the patients' conditions.
A total of 13 patients completed the 24-month follow-up assessment and achieved bone re-union at Hoffa fracture sites. The average follow-up period was 24.5 months (ranging from 24 to 28 months). Six patients were treated by DFCLP in combination with cannulated screws and the remaining seven patients were treated by DFCLP alone. The mean ROM was determined as 119° (ranging from 100° to 130°). The mean KSS score was 87.9 (ranging from 80 to 92 points), with 11 patients evaluated as excellent, two as good, and zero bad cases. The mean IKDC score was 84.2 (ranging from 74.7 to 89.7 points), with 10 evaluated as excellent, three as good, and zero bad cases. The mean IKDC score was 83.3 for patients with medial Hoffa fractures and 84.4 for those with lateral Hoffa fractures. The average time to healing was 3.5 months (ranging from 3 to 4 months), and at month 3, the fracture healing was evident in seven patients (54%), and at month 4, fracture healing was seen in six patients (46%). It is worth mentioning that two patients suffered from knee joint stiffness and osteoarthritis during the 24 months follow-up. Eleven patients (84.6%) achieved satisfactory knee joint function through early postoperative rehabilitation.
In patients with Hoffa fractures, treatment with DFCLP alone or in combination with cannulated screws followed by early active rehabilitation resulted in great stability and satisfactory functional outcomes after 24 months. Our findings may provide surgeons with a new way to treat Hoffa fractures.
探讨股骨远端髁锁定板（DFCLP）单独或联合空心螺钉治疗Hoffa 骨折的疗效。
本研究回顾性分析了 2014 年 5 月至 2019 年 2 月期间收治的 13 例年龄 26-64 岁的单纯 Hoffa 骨折患者。所有患者均采用 DFCLP 单独或联合空心螺钉进行切开复位内固定治疗，术后早期进行积极康复。主要观察指标为患者术后 24 个月的膝关节活动度（ROM）、膝关节学会评分（KSS）、国际膝关节文献委员会（IKDC）评分系统以及骨折愈合时间。同时评估术后并发症。
共 13 例患者完成 24 个月随访，Hoffa 骨折部位均愈合。平均随访时间 24.5 个月（24-28 个月）。6 例患者采用 DFCLP 联合空心螺钉治疗，7 例患者采用 DFCLP 单独治疗。ROM 平均为 119°（100°-130°）。KSS 评分平均为 87.9（80-92 分），其中优 11 例，良 2 例，可 0 例。IKDC 评分平均为 84.2（74.7-89.7 分），其中优 10 例，良 3 例，可 0 例。内侧 Hoffa 骨折患者的 IKDC 评分为 83.3，外侧 Hoffa 骨折患者的 IKDC 评分为 84.4。骨折愈合时间平均为 3.5 个月（3-4 个月）。术后 3 个月时，7 例（54%）患者骨折愈合，术后 4 个月时，6 例（46%）患者骨折愈合。值得注意的是，2 例患者在 24 个月随访中出现膝关节僵硬和骨关节炎。11 例（84.6%）患者通过早期术后康复获得了满意的膝关节功能。
DFCLP 单独或联合空心螺钉治疗 Hoffa 骨折，结合早期积极康复，24 个月后膝关节稳定性和功能恢复良好。本研究结果可为 Hoffa 骨折的治疗提供新的思路。
