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| Min Li,Tu Chongqi,Wang Guanglin,Fang Yue,Duan Hong,Liu Lei,Zhang Hui.[J].Chin J Traumatol,2014,17(2):79-83. [doi] |
| Internal fixation with headless compression screws andback buttress plate for treatment of old Hoffa fracture |
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| DOI： |
| KeyWord: Fractures, bone Fracture fixation,
internal Intra-articular fractures |
| FundProject: |
| Author Name | Affiliation | | Min Li | Department of Orthopedics, West China Hospital,
Chengdu 610041, China | | Tu Chongqi | Department of Orthopedics, West China Hospital,
Chengdu 610042, China | | Wang Guanglin | Department of Orthopedics, West China Hospital,
Chengdu 610043, China | | Fang Yue | Department of Orthopedics, West China Hospital,
Chengdu 610044, China | | Duan Hong | Department of Orthopedics, West China Hospital,
Chengdu 610045, China | | Liu Lei | Department of Orthopedics, West China Hospital,
Chengdu 610046, China | | Zhang Hui | Department of Orthopedics, West China Hospital,
Chengdu 610047, China |
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| Abstract: |
| Objective: To analyze the early clinical and radiographic outcomes of Hoffa fractures treated by a standard protocol of open reduction and internal fixation using headless compression screws combined
with back buttress plate in a consecutive series of 8 Chinese patients.
Methods: Open reduction and internal fixation was performed on all patients. The fractures were anatomically reduced and held temporarily by K-wire. If the ends of fractures were atrophic, autologous bone graft from the ipsilateral iliac crest was packed between the ends. Then the fracture fragments were fixed with AO 6.5 mm headless compression cannulated screws. At least two screws
were used to provide rotational stability. One pre-contoured reconstruction plate was placed on the nonarticular surface posteromedially or posterolaterally as back buttress plate.
Results: All the patients were followed up for at least 12 months (range 12-25 months). All fractures
achieved anatomical reduction and healed clinically and radiographically. At recent follow-up, the mean flexion degree was 120.6° (range 110°-135°) and the mean extension degree was 2.5° (range 0°-5°). The average visual analogue scale score was 1.6 points (range 0-3). Six patients were assessed as excellent and 2 as good according to the hospital for special surgery knee score system.
There were no superficial or deep infections, or hardware breakages. No patient had giving way or locking of the knee, though some had intermittent pain and swelling after strenuous exercise. Injury mechanism had significant influence on the functional outcome (P=0.046).
Conclusion: Headless compression screws combined with back buttress plate and/or autologous bone
grafting to treat old Hoffa fracture is one of effective measures. It would be conducive to not only fracture healing but also early exercise and functional recovery. |
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