Discussion on internal fixation of Hoffa fractures.
10.12200/j.issn.1003-0034.2023.12.019
- Author:
Wan-Kui ZHANG
1
,
2
;
Tian-Yun ZHAO
1
,
2
Author Information
1. The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China
2. Department of Sports Medicine, Tianshui First People's Hospital, Tianshui 741000, Gansu, China.
- Publication Type:Journal Article
- Keywords:
Cartilage injury;
Hoffa fracture;
Internal fixation;
Shear stress
- MeSH:
Humans;
Hoffa Fracture;
Femoral Fractures/surgery*;
Tomography, X-Ray Computed;
Fracture Fixation, Internal/methods*;
Bone Plates;
Iatrogenic Disease
- From:
China Journal of Orthopaedics and Traumatology
2023;36(12):1207-1210
- CountryChina
- Language:Chinese
-
Abstract:
Hoffa fracture is an unstable intra-articular fracture with significant redisplacement tendency. It is easy to be missed diagnosis when accompanied by distal intercondylar or supracondylar fracture of femur. CT scan is the gold standard for the diagnosis of Hoffa fracture. The treatment principles are anatomic reduction of the articular surface, reliable internal fixation, and early functional activity. At present, the main treatment is arthroscopic screw fixation. During screw fixation, the tail cap of screw should be buried, resulting in non-healing iatrogenic injury of articular cartilage. In the early postoperative functional activity of knee joint, fracture block was repeatedly subjected to backward and upward shear force under the action of the tibial plateau, which is the main reason for the failure of internal fixation. Plate assisted screw fixation could increase local mechanical stability, but it still cannot avoid the defects of iatrogenic cartilage injury. At the same time, plate molding is required during the operation due to the absence of special anatomical plates, resulting in increased surgical trauma and time-consuming surgery. The ideal fixation method for Hoffa fracture should include:(1) Avoid iatrogenic injury of articular surface cartilage. (2) With the rear anti-shear barrier plate function.(3) The internal fixator is closer to the load interface, so as to obtain greater load and better fixed strength.
