The Comparison Of Effect Of Two Different Surgical Procedures For Treatment Of Letenneur Type Ⅰ Hoffa Fractures In Lateral Condyles

Objective: In this study,we collected Letenneur type I Hoffa fractures that occurred on the lateral condylar of the single knee and fixed by a additional buttress plate combined with lag screws or only two lag screws。The contrastive analysis was used to investigate which surgical treatment of Letenneur type I Hoffa fractures in lateral condyles have more advantages in the fracture healing time and knee function recovery and other clinical efficacy,aim at providing clinical evidence for choosing treatment.Material and mehods: During the study period(January 2000-January 2016),according to the exclusion criteria、 the diagnostic criteria and inclusion criteria,A total of 42 patients was diagnosed as a Letenneur type I Hoffa fracture on the lateral condylar of a single knee In surgery in the Second Affiliated Hospital of Dalian Medical University.All fractures were fixed by a additional plate combined with lag screws or only two lag screws,then they were labeled as group A,group B,respectively.There were 24 patients in Group A.There were 18 patients in Group B.Early active rehabilitation was instituted after the surgical treatment。The intraoperative blood loss was compared by refering the surgical record.By comparing the imaging and fracture healing criteria,the fracture healing time were compared and analyzed.Knee Society Score(KSS)and Hoffa Fracture Postoperative Functional Recovery Assessment System(Letenneur Score)though questionnaire was used to evaluate the stability and function of the knee joint.Results: All the incisions were healed in the first stage,and all Hoffa fractures inlateral femoral condylar Hoffa were healeds.There was no early complication.The femoral condyle fractures are anatomically resuscitated.Through early postoperative active rehabilitation exercise,the majority of patients is satisfied with knee function which can restore the ability to walk and achieve a good clinical results.The incidence of postoperative long-term complication in group A was 16.67%,the lntraoperative average blood loss was 140 ± 15.65 ml,The average healing time was 12.32 ± 1.21 weeks.A total of 18 cases with Letenneur Score were excellent and the excellent and good rate was 75%.A total of 19 cases with knee KSS score were excellent and the excellent and good rate was 79.17%.The incidence of postoperative long-term complication in group B was 27.78%,the lntraoperative average blood loss was102±12.32 ml,The average healing time was 11.67±1.10 weeks.13 cases with Letenneur Score were excellent and the excellent and good rate was 72.22%.13 cases with knee KSS score were excellent and the excellent and good rate was 72.22%.Two groups of data were obtained by t-test,there was no statistical difference in fracture healing time 、.Two groups of data were obtained by chi-square test,there was no statistical difference in postoperative knee function score.Conclusion: In the application of a additional buttress plate combined with lag screws or simple tension screw for Letenneur type I Hoffa fracture occurred in the distal femoral distal lateral condylar Letenneur type I Hoffa fracture,postoperative through active rehabilitation exercise,knee function can achieve satisfactory results,Both are currently effective methods for the treatment of Letenneur type I Hoffa fractures in the distal lateral condyle.There are no significant differences between the two methods in the time of fracture healing and there is no significant difference in clinical efficacy.Simple tension screw therapy may have the advantage of less intraoperative bleeding There was no significant difference between the two methods in fracture healing time.