Objective To observe the clinical efficacy of hollow screws combined with calcaneal locking plate in treating com-minuted Letenneur type Ⅰ and Ⅲ Hoffa fractures.Methods A retrospective analysis was performed on 14 cases of Letenneur type Ⅰ and Ⅲ comminuted Hoffa fractures treated from October 2017 to June 2022.After fracture reduction,one to three guide pins were placed from posterior to anterior under knee flexion.The guide pins were directed to the main fracture line on the ver-tical sagittal plane as possible,and then hollow screws of appropriate length were inserted.According to fracture type and calca-neal fracture line,locking plate was selected,the plate was positioned on the right place after bending,trimming,attention should be paid to the position of the lateral collateral ligament check point,to avoid its irritability,at the same time 3 or 4 screws as much as possible were inserted into distal fracture block to increase holding force.Results All patients were followed up for 10-28 months(mean,14.9 months).No complications such as infection,lower extremity deep vein thrombosis,internal fixation loosening and breakage,nonunion fracture,knee joint stiffness or avascular necrosis of the femoral condyle occurred,2 cases had traumatic arthritis during the follow-up period.The range of motion of knee joint was 114°-120°(mean,117.2°)at 3 months after operation.The range of motion of knee joint was 119°-125°(mean,121.4°)at 6 months after operation.Fracture healing time was 12-17 weeks,an average of 14.7 weeks.The curative effectat the last follow-up evaluation with knee KSS score stan-dard:excellent in 11 cases,good in 2 cases,fair in 1 case.Conclusion The clinical outcomes are satisfactory for the treatment of comminuted Letenneur type Ⅰ and Ⅲ Hoffa fractures with hollow screws combined with calcaneal locking plate.It can effec-tively fix the comminuted bone fragments,which is beneficial to fracture healing and knee joint function recovery.
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