摘要
目的探讨空心拉力螺钉结合钢板内固定治疗LetenneurⅠ、Ⅲ型Hoffa骨折的方法及临床疗效。方法自2009-03—2012-08共诊治9例（10髁）Hoffa骨折,其中内侧3髁,外侧7髁,按Letenneur分型：Ⅰ型6髁,Ⅲ型4髁。其中7髁（Ⅰ型骨折6例,Ⅲ型骨折1例）行空心钉结合后方防滑钢板或侧方支撑钢板内固定,3髁（Ⅲ型骨折）行空心钉结合侧方支撑钢板内固定。术后按照Letenneur功能恢复评估系统评定疗效。结果所有患者均获得随访6~47个月,平均16.7个月。骨折均骨性愈合,愈合时间12~30周,平均18.3周。无内固定松动断裂、感染及股骨髁坏死等并发症发生。术后疗效：优良9髁,差1髁。结论 Hoffa骨折行切开解剖复位空心拉力螺钉结合后方防滑钢板或侧方支撑钢板内固定术,可达到固定坚强可靠、术后能早期功能锻炼、术后功能恢复良好、术后并发症少的治疗效果。
Objective To explore the operating methods and clinical effects of the treatment of type Ⅰ、Ⅲ Hoffa fracture with hollow lag screws combined with plates. Methods Nine patients with Hoffa fracture （10 condyles） were treated from March 2009 to August 2012. There were 3 cases of medial femoral condyle fracture and 7 cases of lateral femoral condyle fracture. According to the modified Letenneur＇s classification, there were 6 cases of type Ⅰ condylefraeture and 4 cases of type Ⅲ condyles of. Seven cases of condyle fracture （6 type Ⅰ and 1 type Ⅲ） were fixed with eanulated screws plus posterior antisliding plates or canulated screws plus lateral supporting plates, 3 cases of condyle fracture（type Ⅲ ）were fixed with canulated screws plus lateral supporting plates. After operation, the clinical effects were evaluated with Letenneur＇s functional assessment system. Results All the patients were followed up for an average of 16. 7 months （from 6 to 47 months）. All the condyles obtained bony union after an average of 18, 3 weeks （from 12 to 30 weeks）, There was no infection, implant failure, implant＇ disruption or bone necrosis. Nine condyles were excellent or good and 1 poor, with a good-to-excellent rate of 90%. Conclusion Hoffa fracture should be treated with open and anatomic reduction and internal fixation with lag screws combined with lateral supporting plates or posterior anti-sliding plates. This technique which can ensure firm fixation, early rehabilitation exercise after operation, satisfactory functional restoration, is also an ideal way with few postoperative complications.
出处
《中国骨与关节损伤杂志》
2014年第12期1218-1220,共3页
Chinese Journal of Bone and Joint Injury
基金
福建省科技计划项目(2013D013)
