Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

Erçin, Ersin; Bilgili, Mustafa Gökhan; Başaran, Serdar Hakan; Baca, Emre; Kural, Cemal; Avkan, Mustafa Cevdet

doi:10.1016/j.eats.2013.06.001

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…Few reports of ARIF of femoral condyle fractures are available. [17][18][19][20][21] Wallenbock and Ledinski 17 in a series of 24 patients of intraarticular knee fractures treated two Hoffa fractures with ARIF. They acknowledge the challenging and demanding nature of work involved in arthroscopic fixation and reported good early results, but they did not describe specifically the technique or outcome of the patients with coronal fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Although their fixation did not appear to achieve rigid compression, 19 they highlighted reduced soft tissue dissection, blood loss, and operative time and a faster recovery time after arthroscopic management as advantages. Ercin et al 21 described arthroscopy as an important diagnostic tool for management of fixation of these coronal fractures and nonunions. They also advocated that arthroscopy could be considered in all such injuries as associated articular pathologies may be overlooked by clinical or radiological means.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic-assisted fixation of Hoffa fracture: A case report and description of technique

Goel

Sabat

Agrawal

2016

Journal of Clinical Orthopaedics and Trauma

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Medial condyle Hoffa fractures are intra articular injuries, which require prompt anatomical reduction and internal fixation. Arthroscopy-guided fixation of these fractures has also been advocated; the advantages include avoidance of soft tissue dissection, fast recovery and mobilization. We describe a case of a 28-year-old male patient presenting with a 10-day-old medial condylar Hoffa fracture. Skin condition prevented from conventional open reduction and internal fixation; hence, taking note of the urgency of fixation of an intraarticular fracture, arthroscopic-assisted minimally invasive approach was performed with good outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arthroscopic-assisted fixation of Hoffa fracture: A case report and description of technique

Goel

Sabat

Agrawal

2016

Journal of Clinical Orthopaedics and Trauma

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“…Additional intraarticular injuries such as meniscal tears, chondral lesions, or ACL injuries can be diagnosed and treated as usual, with these arthroscopic techniques. 7 It has been recommended that grafting of the depressed area should be an essential part of the treatment. 8 We prefer a medially based metaphyseal window for lateral tibial plateau fracture because of the advantage of the longer tunnel for better subchondral support as stated in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy

Ozkut

Poyanlı

Erçin

et al. 2017

Arthroscopy Techniques

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Accurate reduction and maintenance of the stability with correct implant positioning is critical for surgical treatment of tibial plateau fractures. Our technique includes an arthroscopic reduction and fixation of Schatzker type III tibial plateau fractures with a bulls-eye screw placement without fluoroscopy control. With the arthroscopic guidance, an anterior cruciate ligament drill guide is placed and a K-wire sent to the midpoint of the depressed fragment through the guide at a 40 angle to the coronal axis of the tibia. A tunnel is created with the drill over the K-wire. The depressed fragment is further augmented with gentle impacts over the K-wire. After arthroscopic reduction control, an appropriatesized iliac graft is pushed until it is below the depressed fragment. The targeting device is adjusted at 130 so that it is parallel to the joint line and a K-wire sent through the device so that it would pass just below the graft. The graft is then supported with cannulated screws sent over the K-wire. This technique provides an arthroscopic reduction of the chondral surface and precise placement of the rafting screws without fluoroscopy.L ong-term clinical results of tibial plate fractures are dependent on the quality of the intra-articular reduction of the articular surface. 1 Excessive dissection of the injured soft tissue envelope and devitalization of bone fragments are the primary concerns of the open techniques. To eliminate the problems related to the open techniques, many authors recommended minimally invasive reduction and stabilization techniques such as isolated lateral plating with medial external fixation, hybrid external fixation, tensionedwire fixation, and percutaneous reduction. [2][3][4] In Schatzker type III tibia plateau fractures, exploration of the fracture site is challenging because the lateral plateau is not displaced. Arthroscopic reduction and internal fixation are recommended as a safe and reliable method for treatment of tibia plateau fractures. 4 With arthroscopic-assisted techniques, the reduction of the depressed fragment can be performed indirectly without excessive dissection.Inherent advantages of arthroscopic-assisted techniques include less soft tissue stripping and lesser wound site complications. To avoid these complications, arthroscopic-assisted techniques that involve restoration of the depressed joint surface and grafting under the

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“…[7,10] The finding of medial or lateral stress test and anterior and posterior drawer test were reported to be positive in some patients. [39,40] Wagih [41] reported that, under general anesthesia, patients with Hoffa fracture have instability at 30° of flexion but not with leg straightened.…”

Section: Diagnosismentioning

confidence: 99%

Hoffa fracture of the femoral condyle

et al. 2019

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Background: Hoffa fractures are coronal-plane fractures of the femoral condyle, which are rarer than sagittal-plane condylar fractures. This study aimed to systematically review the clinical knowledge base of Hoffa fractures to facilitate the diagnosis and management of such injuries. Methods: We searched Medline, Embase, Cochrane Library, Google Scholar, China National Knowledge Infrastructure, and China Biology Medicine disc, using the terms “Hoffa fracture” and “coronal fracture of femoral condyle.” Results: One hundred five articles on Hoffa fractures were reviewed, and the clinical knowledge base was summarized. High-energy trauma is a common cause of a Hoffa fracture, although low-energy trauma and iatrogenic injury can also lead to these fractures. Commonly used classifications include the Letenneur classification, a computed tomography (CT) classification, the AO classification, and modified AO classification. Radiography can reveal fracture lines. If radiographic findings are negative in questionable cases, CT and magnetic resonance imaging (MRI) should be performed. Nondisplaced fractures can be managed conservatively; however, they involve a high risk of redisplacement. Open reduction and internal fixation are preferred. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. For bicondylar fractures, a median parapatellar incision can be used. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. Conclusion: Here, we summarized the injury mechanism, diagnosis, classification, and treatment options of Hoffa fractures.

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Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

Cited by 15 publications

References 7 publications

Arthroscopic-assisted fixation of Hoffa fracture: A case report and description of technique

Arthroscopic-assisted fixation of Hoffa fracture: A case report and description of technique

Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy

Hoffa fracture of the femoral condyle

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