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内侧 Hoffa 骨折:一种入路和治疗方法的病例报告及文献复习。

Medial Hoffa Fracture: A Case Report and Literature Review of Approach and Management.

机构信息

Department of Orthopedic Surgery, Mutah University, Amman, Jordan.

Department of Orthopedic Surgery, Hashemite University, Zarqa, Jordan.

出版信息

Am J Case Rep. 2024 May 6;25:e943136. doi: 10.12659/AJCR.943136.

DOI:10.12659/AJCR.943136
PMID:38706183
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11087669/
Abstract

BACKGROUND Hoffa fractures are an uncommon form of coronal fracture that impact the femoral condyle. As a result, they are not very prevalent. It is necessary to perform anatomical reduction and rigorous fixation on these fractures; however, there is no consensus among medical professionals on the surgical procedure and implant that would be the most successful in treating these fractures. CASE REPORT A 50-year-old woman who had poliomyelitis in her right lower limb presented with a displaced medial Hoffa fracture of her left knee. She had fallen and was suffering from poliomyelitis. The trauma that caused this fracture had a modest energy level. Open reduction and internal fixation with 2 retrograde cannulated screws were included in her surgical procedure. An approach known as the medial parapatellar route was used for this treatment. As part of her postoperative rehabilitation, she participated in physiotherapy, exercises that did not require weight bearing, exercises that used passive and active assistance, activities that involved partial and full weight bearing, and exercises that involved complete weight bearing. At the 2-year follow-up, the patient's left knee continued to be painless and stable, and it had unrestricted range of motion across the whole extremity. It was determined via radiographs that the fracture had healed without any problems or arthritic changes developing. She was able to walk without help and carry out her daily tasks since she was able to walk with the use of a cane. CONCLUSIONS Retrograde cannulated screws can be a reliable and successful choice for treatment of medial Hoffa fractures, with positive results according to both clinical and radiographic characteristics. Further research is needed to analyze the outcomes over a longer period of time and make comparisons between this technique and others.

摘要

背景

Hoffa 骨折是一种罕见的冠状骨折,影响股骨髁。因此,它们并不常见。有必要对这些骨折进行解剖复位和严格固定;然而,对于治疗这些骨折最成功的手术程序和植入物,医学界没有达成共识。

病例报告

一名 50 岁女性,右下肢患有小儿麻痹症,左膝内侧 Hoffa 骨折移位。她跌倒了,患有小儿麻痹症。导致这次骨折的创伤能量水平适中。她的手术包括切开复位和 2 枚逆行空心螺钉内固定。采用内侧髌旁入路进行治疗。作为术后康复的一部分,她接受了物理治疗,包括不负重运动、被动和主动辅助运动、部分和完全负重活动以及完全负重运动。在 2 年的随访中,患者的左膝继续无痛且稳定,整个下肢的活动范围不受限制。影像学检查显示骨折愈合良好,没有出现任何问题或关节炎变化。她能够在使用手杖的情况下独立行走并进行日常活动。

结论

逆行空心螺钉是治疗内侧 Hoffa 骨折的可靠且成功的选择,根据临床和影像学特征,结果均为阳性。需要进一步研究来分析更长时间的结果,并比较该技术与其他技术的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/e40008591132/amjcaserep-25-e943136-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/27a319e0403d/amjcaserep-25-e943136-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/71fd966af73b/amjcaserep-25-e943136-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/85dc76bce371/amjcaserep-25-e943136-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/b97618f1c419/amjcaserep-25-e943136-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/e40008591132/amjcaserep-25-e943136-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/27a319e0403d/amjcaserep-25-e943136-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/71fd966af73b/amjcaserep-25-e943136-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/85dc76bce371/amjcaserep-25-e943136-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/b97618f1c419/amjcaserep-25-e943136-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6395/11087669/e40008591132/amjcaserep-25-e943136-g005.jpg

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Z Orthop Unfall. 2022 Jun;160(3):269-277. doi: 10.1055/a-1289-1102. Epub 2020 Dec 9.
2
A proposed radiological classification system of Hoffa's fracture based on fracture configuration and consequent optimal treatment strategy along with the review of literature.基于骨折形态及相应最佳治疗策略的Hoffa骨折放射学分类系统的提议及文献综述。
SICOT J. 2019;5:18. doi: 10.1051/sicotj/2019016. Epub 2019 Jun 7.
3
晚期就诊的股骨远端关节内骨骺骨折手术治疗的结果:一项多中心回顾性病例系列研究
Indian J Orthop. 2024 Nov 29;58(12):1782-1792. doi: 10.1007/s43465-024-01291-4. eCollection 2024 Dec.
Hoffa fracture of the femoral condyle: Injury mechanism, classification, diagnosis, and treatment.
股骨髁部霍法骨折:损伤机制、分类、诊断及治疗
Medicine (Baltimore). 2019 Feb;98(8):e14633. doi: 10.1097/MD.0000000000014633.
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Corrective Osteotomy for Coronal Plane Malunion of the Medial Femoral Condyle.股骨内侧髁冠状面畸形愈合的矫正截骨术
Cureus. 2018 Aug 28;10(8):e3222. doi: 10.7759/cureus.3222.
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The Hoffa fracture: Coronal fracture of the femoral condyle a review of literature.霍法骨折:股骨髁冠状面骨折——文献综述
J Orthop. 2018 May 7;15(2):726-731. doi: 10.1016/j.jor.2018.05.027. eCollection 2018 Jun.
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