中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2012年
11期
927-930
,共4页
徐培%孙杰%袁天祥%马宝通
徐培%孫傑%袁天祥%馬寶通
서배%손걸%원천상%마보통
股骨骨折%骨折固定术,内%骨钉%骨板
股骨骨摺%骨摺固定術,內%骨釘%骨闆
고골골절%골절고정술,내%골정%골판
Femoral fractures%Fracture fixation,internal%Bone nails%Bone plates
目的 探讨拉力螺钉辅加抗滑钢板内固定治疗Hoffa骨折的疗效. 方法 回顾性分析2007年12月至2011年11月手术治疗的12例(14髁)Hoffa骨折患者资料,男8例(10髁),女4例(4髁)；年龄20～ 61岁,平均36.2岁.Hoffa骨折类型:内髁骨折6例,外髁骨折4例,双髁骨折2例.骨折按AO/OTA分型:33B32型10例,33B33型2例；按Letenneur分型:Ⅰ型7髁,Ⅱ型1髁,Ⅲ型6髁.开放性骨折2例,闭合性骨折10例.合并伤:股骨干骨折1例,胫骨近端骨折3例,踝部骨折1例,伸膝装置损伤2例,交叉韧带损伤4例,内侧副韧带损伤1例,半月板损伤3例.受伤至手术时间平均为3.2d(2 h至7d).所有患者均采用松质骨拉力螺钉结合抗滑钢板同定治疗. 结果 12例患者术后获6 ～ 54个月(平均20.3个月)随访.骨折均获骨性愈合,愈合时间为11 ～23周,平均16.6周.无内固定失效、骨折移位及骨坏死发生.1例患者出现伤口感染,1例患者出现伤口不愈合,经治疗后痊愈.根据Letenneur功能评估标准评定疗效:优良11例,可1例,优良率为91.7％. 结论 拉力螺钉辅加抗滑钢板治疗Hoffa骨折疗效优良、可靠.选择正确的手术入路、解剖复位及坚强固定是治疗成功的关键.
目的 探討拉力螺釘輔加抗滑鋼闆內固定治療Hoffa骨摺的療效. 方法 迴顧性分析2007年12月至2011年11月手術治療的12例(14髁)Hoffa骨摺患者資料,男8例(10髁),女4例(4髁)；年齡20～ 61歲,平均36.2歲.Hoffa骨摺類型:內髁骨摺6例,外髁骨摺4例,雙髁骨摺2例.骨摺按AO/OTA分型:33B32型10例,33B33型2例；按Letenneur分型:Ⅰ型7髁,Ⅱ型1髁,Ⅲ型6髁.開放性骨摺2例,閉閤性骨摺10例.閤併傷:股骨榦骨摺1例,脛骨近耑骨摺3例,踝部骨摺1例,伸膝裝置損傷2例,交扠韌帶損傷4例,內側副韌帶損傷1例,半月闆損傷3例.受傷至手術時間平均為3.2d(2 h至7d).所有患者均採用鬆質骨拉力螺釘結閤抗滑鋼闆同定治療. 結果 12例患者術後穫6 ～ 54箇月(平均20.3箇月)隨訪.骨摺均穫骨性愈閤,愈閤時間為11 ～23週,平均16.6週.無內固定失效、骨摺移位及骨壞死髮生.1例患者齣現傷口感染,1例患者齣現傷口不愈閤,經治療後痊愈.根據Letenneur功能評估標準評定療效:優良11例,可1例,優良率為91.7％. 結論 拉力螺釘輔加抗滑鋼闆治療Hoffa骨摺療效優良、可靠.選擇正確的手術入路、解剖複位及堅彊固定是治療成功的關鍵.
목적 탐토랍력라정보가항활강판내고정치료Hoffa골절적료효. 방법 회고성분석2007년12월지2011년11월수술치료적12례(14과)Hoffa골절환자자료,남8례(10과),녀4례(4과)；년령20～ 61세,평균36.2세.Hoffa골절류형:내과골절6례,외과골절4례,쌍과골절2례.골절안AO/OTA분형:33B32형10례,33B33형2례；안Letenneur분형:Ⅰ형7과,Ⅱ형1과,Ⅲ형6과.개방성골절2례,폐합성골절10례.합병상:고골간골절1례,경골근단골절3례,과부골절1례,신슬장치손상2례,교차인대손상4례,내측부인대손상1례,반월판손상3례.수상지수술시간평균위3.2d(2 h지7d).소유환자균채용송질골랍력라정결합항활강판동정치료. 결과 12례환자술후획6 ～ 54개월(평균20.3개월)수방.골절균획골성유합,유합시간위11 ～23주,평균16.6주.무내고정실효、골절이위급골배사발생.1례환자출현상구감염,1례환자출현상구불유합,경치료후전유.근거Letenneur공능평고표준평정료효:우량11례,가1례,우량솔위91.7％. 결론 랍력라정보가항활강판치료Hoffa골절료효우량、가고.선택정학적수술입로、해부복위급견강고정시치료성공적관건.
Objective To investigate the clinical efficacy of internal fixation with lag screws plus an auxiliary sliding plate for the treatment of Hoffa fractures.Methods A retrospective analysis was made for 12 patients (14 condyles) with Hoffa fracture who had been treated in our hospital from December 2007 through November 2011.They were 8 males (10 condyles) and 4 females (4 condyles),with an average age of 36.2 years (range,from 20 to 61 years).By the Hoffa classification,6 cases were medial condylar fractures,4 lateral condylar fractures and 2 bicondylar fractures.By the AO/OTA classification,10 cases were type 33B32 and 2 type 33B33.By Letenneur's classification,7 condyles were type Ⅰ,one condyle was type Ⅱ and 6 condyles were type Ⅲ.There were 2 open fractures and 10 closed ones.Femoral shaft fracture was complicated in one case,proximal tibia fracture in 3 cases,ankle fracture in one,injury to the knee extensor mechanism in 2,cruciate ligament injury in 4,medial collateral ligament injury in one,and meniscus injury in 3.The time from injury to surgery averaged 3.2 days (from 2 hours to 7 days).All fractures were reduced under direct vision and fixated with cancellous lag screws plus an additional anti-sliding plate.Results All the patients were followed for 6 to 54 months (average,20.3 months).Union was achieved in all patients after an average time of 16.6 weeks (from 11 to 23 weeks).No implant failure or fracture displacement occurred.Incision infection and incision disunion occurred in one case each,but both were cured after intensive care.According to Letenneur's functional assessment,11 cases were excellent or good and one case was fair,giving a good to excellent rate of 91.7％.Conclusions Open reduction and internal fixation with lag screws and an additional anti-sliding plate may result in excellent results for Hoffa fractures.The key to a successful surgery is an appropriate approach,anatomic reduction and rigid fixation.
