Operative management of Hoffa fractures-A prospective review of 18 patients
Operative management of Hoffa fractures-A prospective review of 18 patients
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DOI：
10.1016/j.injury.2011.09.005
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发表时间：
2011-12-01
影响因子：
2.5
通讯作者：
Krishnamurthy, Mukunth
中科院分区：
文献类型：
--
作者：
Gavaskar, Ashok S.;Tummala, Naveen Chowdary;Krishnamurthy, Mukunth
目的：Hoffa骨折代表股髁冠状面骨折。孤立的Hoffa骨折是罕见的，目前对这些骨折的治疗是基于文献中的一些描述。该研究的目的是前瞻性地分析开放手术治疗后的临床放射学和功能结果。患者和方法：在29个月的研究期间，共发现18例孤立的Hoffa骨折。所有骨折均经髌旁内侧入路切开复位治疗。用螺钉在前后/后前（AP/PA）方向进行内固定。术后立即积极活动，限制负重。随访至1年，使用膝关节学会评分和国际膝关节文献委员会评分进行放射学和功能结果分析。结果：所有患者均愈合。除1例患者外，其余患者关节面均解剖复位。没有复位或固定的损失。功能结果测量显示，在1年的随访期间，功能持续显著改善。并发症包括1例患者僵硬和疼痛，2例患者侧支松弛，1例患者关节炎进展。结论：Hoffa骨折是关节内骨折，最好的治疗方法是解剖复位和刚性固定，然后早期活动。切开复位增加了实现解剖复位的机会，并在配合积极的康复治疗时提供了令人满意的功能结果。(C) 2011 Elsevier Ltd.版权所有。
Objectives: Hoffa fractures represent coronal fractures of the femoral condyles. Isolated Hoffa fractures are rare and current management of these fractures is based on a few descriptions in literature. The goal of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment.Patients and methods: A total of 18 isolated Hoffa fractures were identified during the study period spanning 29 months. All fractures were treated by open reduction through a medial parapatellar approach. Internal fixation was performed with screws in the anteroposterior/posteroanterior (AP/PA) direction. Immediate active mobilisation with restricted weight bearing was instituted postoperatively. Radiological and functional outcome analysis using Knee Society scores and International Knee Documentation Committee scores were performed at follow-up visits until 1 year.Results: Union was achieved in all patients. The articular surface was reduced anatomically in all but one patient. There was no loss of reduction or fixation. Functional outcome measures showed a continuous significant improvement in function over the 1-year follow up period. Complications include stiffness and pain in one patient, collateral laxity in two patients and progression of arthritis in one patient.Conclusion: Hoffa fractures are intra-articular and are best treated by anatomical reduction and rigid fixation followed by early mobilisation. Open reduction increases the chances of achieving anatomical reduction and gives satisfactory functional results when coupled with aggressive rehabilitation. (C) 2011 Elsevier Ltd. All rights reserved.