[Hoffa骨折:罕见,常被忽视,易发生并发症]。

Hannah Gablac, Michael Hoffmann
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引用次数: 0

摘要

Hoffa骨折是股髁的冠状面骨折,总体上是一种罕见的骨折。这些骨折主要是由高能创伤引起的,通常累及股骨外侧髁。股骨髁受轴向载荷,膝关节屈曲90°或以上,形成典型的骨折模式。在最初的放射学诊断中,骨折经常被忽视,因此,计算机断层扫描(CT)检查被用于诊断和手术计划(选择通路和植入物)。与Herbert螺钉相当的手术治疗获得了良好的功能效果,这与无碎片区单纯Hoffa骨折的首选骨植入物相对应。半月板、软骨和韧带病变是Hoffa骨折常见的附带损伤,并可影响功能预后。因此,建议进行额外的磁共振成像(MRI)诊断和术中稳定性测试。尽管有不同的诊断和治疗,但Hoffa骨折的轨迹通常与并发症有关,因此需要有结构的康复方案和放射控制的随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Hoffa fractures : Rare, often overlooked, prone to complications].

Hoffa fractures are coronal plane fractures of the femoral condyle and overall represent a rare fracture entity. These fractures are predominantly caused by high-energy trauma und usually involve the lateral femoral condyle. An axial load to the femoral condyle with the knee in 90° or more of flexion produces the typical fracture pattern. In the initial radiological diagnostics the fracture is often overlooked, therefore, a computed tomography (CT) examination is indicated for the diagnostics and planning of surgery (selection of the access and the implant). The operative treatment with an equivalent of the Herbert screw achieves a good functional result, which corresponds to the preferred osteosynthesis implant for simple Hoffa fractures without a debris zone. Meniscal, chondral and ligamentous lesions are frequent collateral injuries of Hoffa fractures and can impact on the functional outcome. Therefore, additional magnetic resonance imaging (MRI) diagnostics and intraoperative stability tests are recommended. Despite differentiated diagnostics and management the trajectory of Hoffa fractures is often associated with complications and therefore require a structured rehabilitation protocol and follow-up with radiological controls.

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