股骨髁冠状面骨折的分型与治疗  

Classification and treatment of the coronal fractures of the femoral condyle

作　　者：时宏富[1] 蔡贤华[1] 汪国栋[1] 王华松[1] 陈庄洪[1] 

机构地区：[1]广州军区武汉总医院骨科,武汉430070

出　　处：《中华创伤骨科杂志》2007年第2期118-121,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨股骨髁冠状面骨折的分型与治疗方法。方法 对1999年3月-2005年12月治疗的9例（12髁）股骨髁冠状面骨折患者，采用改良Letenneur分型：Ⅰ型5例6髁，Ⅱ型2例2髁，Ⅲ型2例4髁。根据骨折类型和伤情特点分别行前外（内）侧、后外（内）侧及膝前马蹄形切口入路显露，直视下复位，松质骨拉力螺钉或克氏针内固定。结果 所有患者获得6个月～2年随访，骨折均获骨性愈合，愈合时间为6～12周，无骨不愈合及骨坏死发生。根据Letenneur等的Hoffa骨折术后功能评估标准：优良5例，可4例。结论 切开复位拉力螺钉内固定是治疗股骨髁冠状面骨折的主要方法，Ⅰ、Ⅲ型骨折宜用前外侧或内侧入路，Ⅱ型骨折则宜用后外侧或内侧入路。合并伸膝装置损伤的双髁骨折，则膝前马蹄形切口显露较充分。Objective To investigate the classification and surgical treatment of the coronal fractures of the femoral condyle. Methods Nine patients with Hoffa fracture treated in our hospital in recent 6 years were enrolled in this study. According to the modified Letenneur＇ s method, there were 5 cases （6 condyles） of type Ⅰ, 2 cases （2 condyles） of type Ⅱ, and 2 cases （4 condyles） of type Ⅲ, Depending on the type and characteristics of the fracture, the anterolateral / anteromedial, or posterolateral / posteromedial, or anterior horseshoe incision approach was used. Fractures were reduced under direct vision and fixed with cancellous lag screw or Kirschner＇ s wire. Results All the patients were followed up for 6 months to 2 years. According to Letenneur＇s functional assessment system, 5 cases were excellent and good, 4 cases fine, and none poor, Conclusions Open reduction and rigid internal fixation with lag screw is the chief method of treating coronal fractures of the femoral condyle. Anterolateral / anteromedial approaches are ideal for fractures of typeⅠand type Ⅲ, and posterolateral / posteromedial approaches are ideal for type Ⅱ. For bicondylar fractures associated with injury to extensor mechanism, the anterior horseshoe incision approach can provide excellent visualization, and facilitate the reduction and internal fixation.

关 键 词：HOFFA骨折 股骨髁 分型 骨折固定术 内 

分 类 号：R686[医药卫生—骨科学]