Clinical effect of internal fixation of Hoffa fracture / 中华创伤杂志

Objective To approach the methods and effects of internal fixation for Hoffa fracture. Methods A total of 26 patients with 26 condylar Hoffa fractures ( medial condylar fractures in 13patients and lateral condylar fractures in 13) treated from August 1993 to February 2010 were retrospectively analyzed.According to the Letenneur classification,there were 16 patients with type Ⅰ fractures,four with type Ⅱ fractures and six with type Ⅲ fractures.Among them,two patients were with open fractures and 24 with closed fractures.Surgical approaches including screw fixation in 21 patients and lateral support plate fixation in five were selected based on the fracture types and affected sides. Results All patients were followed up for 12.5-48 months (average 18 months),which showed fracture healing in all the patients within 3-4 months (average 3.5 months).Two patients had slight shift together with knee joint pain,ie,one patient had ROM of knee for 95 °,and one failed the functional exercise because of pain and had ROM of knee for 60° during follow up.No complications including infection,delayed union or bone necrosis occurred.According to Letenneur' s functional assessment system,the postoperative outcomes were excellent and good in 24 condyles,fair in one and poor in one. Conclusions Surgical treatment for Hoffa fractures is safe and effective,but the key point is to choose correct screw fixation position and orientation according to the fracture types and fracture fragment size.

Interventional therapy of acute mesenteric venous thrombosis / 中国医师进修杂志

Objective To assess the efficiency and methods of the interventional management in acute mesenteric venous thrombosis (AMVT). Methods Fifteen patients with AMVT who diagnosed by imageology were treated by interventional procedures. Eight patients were treated by transcatheter superior mesenteric artery thrombolysis with urokinase, 5 cases by percutaneous transhepatic treatment, 2 cases by transjugular intrahepatic portosystemic shunt approach. Results The technical success was achieved in all the 15 cases without complications. The majority of the thrombus was cleared by interventional procedures and flow restorated on the angiograms. All the patients with follow-up from 10 to 22 months showed no recurrence. Conclusion The minimally invasive interventional techniques are safe and effective in the treatment of mesenteric venous thrombosis without necrosis.