Coronally Oriented Intra - Articular Distal Femur Hoffa Fracture - How We Deal with It

Abstract

BACKGROUND
 Hoffa fractures are intra-articular femoral condyle fractures in the coronal plane. These are very uncommon injuries. The purpose of this study was radiologic and functional outcome assessment of surgically managed Hoffa fractures with headless compression screws.
 METHODS
 We prospectively studied 11 patients with isolated Hoffa fractures who were treated with open reduction and internal fixation using two or more headless compression screws. Antiglide plate was used only in one case. We used the midline parapatellar approach for all cases. All patients had gone through aggressive physiotherapy after the operation. All patients were evaluated radiologically and functionally on a regular interval. The functional outcome was recorded in terms of Lysholm score, Knee society score (KSS), Range of motion (ROM) and VAS score.
 RESULTS
 All fractures united radiologically with an average time of 3.3 months with no evidence of subsequent fixation failure. The mean Lysholm score and KSS at final follow-up were 88.6±7.1 and 86±7.6 respectively. The mean knee range of motion was from 0˚ to 120.5˚ ± 9.3˚. At the final follow-up, the mean VAS score dropped significantly to 0.63±0.8.
 CONCLUSIONS
 Operative management of Hoffa fractures with at least two headless compression screws can yield satisfactory functional and radiologic outcomes. Stable fixation and timely physiotherapy are the keys to success.