發(fā)布時間：2018-10-05 07:32

【摘要】：目的：探討經(jīng)后路防滑鋼板結(jié)合空心螺釘治療單髁Hoffa骨折的療效,并系統(tǒng)分析Hoffa骨折的損傷機制、臨床診斷、治療方法及臨床隨訪結(jié)果。方法：回顧性分析2009年3月至2014年4月我院采用抗滑鋼板結(jié)合空心螺釘治療9例單髁Hoffa骨折患者的影像學(xué)資料和臨床資料。一般資料：男7例,女2例。平均年齡41歲(28-63歲)。股骨外側(cè)髁骨折6例,股骨內(nèi)側(cè)髁骨折3例。致傷原因：車禍傷5例,高墜傷2例,重物砸傷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。所有患者均行切開復(fù)位、防滑鋼板結(jié)合空心螺釘內(nèi)固定術(shù),累及內(nèi)髁骨折采用膝關(guān)節(jié)后內(nèi)側(cè)入路,累及外髁骨折采用膝關(guān)節(jié)后外側(cè)入路。術(shù)后患者即開始在床上進行限制性的膝關(guān)節(jié)功能鍛煉；術(shù)后6周開始患肢部分負(fù)重鍛煉,術(shù)后8w進行完全負(fù)重鍛煉。骨折復(fù)位質(zhì)量及影像學(xué)隨訪結(jié)果均在膝關(guān)節(jié)正位片、側(cè)位片上進行。膝關(guān)節(jié)預(yù)后功能評分按照Knee Society clinical scores (KSSs)標(biāo)準(zhǔn),在術(shù)后第24個月時評定。結(jié)果：所有骨折均在術(shù)后4個月內(nèi)愈合�；颊咂骄S訪時間為34個月(24-50個月)。7例獲得解剖復(fù)位,2例獲得滿意復(fù)位。所有患者均未發(fā)現(xiàn)復(fù)位喪失及固定失敗。術(shù)后早期發(fā)現(xiàn)傷口感染1例,抗感染1周內(nèi)傷口愈合。隨訪中發(fā)現(xiàn)1例患者發(fā)生膝關(guān)節(jié)僵硬伴疼痛。按膝關(guān)節(jié)(KSSs)評分標(biāo)準(zhǔn),膝關(guān)節(jié)預(yù)后功能優(yōu)4例,良4例,差1例。結(jié)論：防滑鋼板結(jié)合空心螺釘固定Hoffa骨折可對抗股骨髁承受的強大剪切力,具有固定可靠、可早期負(fù)重功能鍛煉等優(yōu)點。
[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，

本文編號：2252534