经后路防滑钢板结合空心钉治疗单髁Hoffa骨折的疗效分析

发布时间：2018-10-05 07:32

【摘要】：目的：探讨经后路防滑钢板结合空心螺钉治疗单髁Hoffa骨折的疗效,并系统分析Hoffa骨折的损伤机制、临床诊断、治疗方法及临床随访结果。方法：回顾性分析2009年3月至2014年4月我院采用抗滑钢板结合空心螺钉治疗9例单髁Hoffa骨折患者的影像学资料和临床资料。一般资料：男7例,女2例。平均年龄41岁(28-63岁)。股骨外侧髁骨折6例,股骨内侧髁骨折3例。致伤原因：车祸伤5例,高坠伤2例,重物砸伤2例。按Letenneur骨折分型,Ⅰ型骨折4例,Ⅱ型骨折2例,Ⅲ型骨折3例。所有患者均行切开复位、防滑钢板结合空心螺钉内固定术,累及内髁骨折采用膝关节后内侧入路,累及外髁骨折采用膝关节后外侧入路。术后患者即开始在床上进行限制性的膝关节功能锻炼；术后6周开始患肢部分负重锻炼,术后8w进行完全负重锻炼。骨折复位质量及影像学随访结果均在膝关节正位片、侧位片上进行。膝关节预后功能评分按照Knee Society clinical scores (KSSs)标准,在术后第24个月时评定。结果：所有骨折均在术后4个月内愈合。患者平均随访时间为34个月(24-50个月)。7例获得解剖复位,2例获得满意复位。所有患者均未发现复位丧失及固定失败。术后早期发现伤口感染1例,抗感染1周内伤口愈合。随访中发现1例患者发生膝关节僵硬伴疼痛。按膝关节(KSSs)评分标准,膝关节预后功能优4例,良4例,差1例。结论：防滑钢板结合空心螺钉固定Hoffa骨折可对抗股骨髁承受的强大剪切力,具有固定可靠、可早期负重功能锻炼等优点。
[Abstract]:Objective: to investigate the effect of posterior antiskid plate combined with hollow screw in the treatment of single condylar Hoffa fracture, and to analyze systematically the injury mechanism, clinical diagnosis, treatment method and clinical follow-up results of Hoffa fracture. Methods: the imaging data and clinical data of 9 patients with single condylar Hoffa fracture treated with antiskid plate combined with hollow screw from March 2009 to April 2014 were retrospectively analyzed. General data: 7 males and 2 females. The average age is 41 (28-63). There were 6 cases of lateral femoral condyle fracture and 3 cases of medial femoral condylar fracture. The causes of injury were: 5 cases of traffic accident, 2 cases of high fall injury and 2 cases of heavy object injury. According to the classification of Letenneur fracture, there were 4 cases of type 鈪，

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