Locking Plate Alone or in Combination with Cannulated Screws for Hoffa Fractures: A Retrospective Study

Li, Zhen; Chen, Zhenyue; Wang, Xiaotan; Li, Jingyin; Jing, Lizhong; Li, Zehui; Cao, Xiufeng

doi:10.1111/os.13201

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…If p-value was less than 0.05 then it was taken as statistically significant. DISCUSSION: Hoffa fracture is an intra-articular coronal fracture of the distal femur 8 . It is one of the more difficult fractures to treat.…”

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confidence: 99%

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2022

IJPSR

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Background: Hoffa fracture management is almost always surgical since it involves the intraarticular part of the femur. It can be managed either with cannulated cancellous screw alone or with the addition of a buttress plate. The study aimed to evaluate and compare the functional outcome of fracture fixation between the CC screw &CC screw with a buttress plate. Method: This was a prospective study of 30 patients with Hoffa fracture conducted between January 2020 to December 2021. Patients were allotted into 2 groups. Group A was treated with CC screw fixation, Group B was treated with CC screw + buttress plate. Post-operatively, follow-up was done for 1 year. Results: There were 14 males and 16 females in our study with both sides equally injured. The mean age of patients was 36.1 ranging from 23 to 52 years. RTA was the most common mode of injury. The average blood loss during group A was 117 ml and for group, B was 182.1 ml which is statistically significant. The average postoperative LKSS score after 3 months was 76.1 for group A and 88.1 for group B which is statistically significant. Conclusion: Hoffa fracture treated with CC screws alone had less blood loss and hospital stay but not significantly better than CC screw with a buttress plate in terms of knee ROM and functional score. Both procedures didn't have significant complications. INTRODUCTION:The Hoffa fracture of the distal femur is a coronal fracture involving one or both of the femoral condyles 1 . These fractures are quite rare and so can be picked up only with a high index of suspicion. Lateral condylar and bilateral condylar fractures are more common than medial condylar fractures 2 . As per the AO/OTA classification, Hoffa fractures come under type 33-B3 3 .

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confidence: 99%

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2022

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Biomechanics of internal fixation in Hoffa fractures – A comparison of four different constructs

Pires,

Rabelo,

Cimini

et al. 2024

Injury

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The effect of screw orientation on internal fixation of Letenneur type II Hoffa fractures: a biomechanics study

Liu,

Lu,

Zheng

2024

BMC Musculoskelet Disord

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Background To investigate the biomechanical effects of screw orientation and fracture block size on the internal fixation system for Letenneur type II Hoffa fractures. Methods The fracture models were randomly divided into six groups according to the fracture subtypes and the direction of nail placement, and a plumb line of the posterior condylar tangent was made across the base of the posterior femoral condyle. The fracture blocks of the three types of fracture were calculated and recorded in the sagittal position, and the biomechanical performance of the six groups was evaluated by biomechanical tests. The axial load on the fracture block at a displacement of 2 mm was set as the failure load, a gradually increasing axial load was applied to each fracture model using a customized indenter at a load of 250-750 N, and the displacements and failure loads of the six groups were recorded at different axial loads. Results Biomechanical test results showed that the larger the fracture block, the greater was the stability when nailing from front to back, and the smaller the fracture block, the greater was the strength when nailing from back to front (p < 0.001). As the fracture block became larger, the biomechanical advantage of nailing from posterior to anterior decreased.The displacement under 250 N load were 1.351 ± 0.113 mm, 1.465 ± 0.073 mm for Group IIa AP and Group IIa PA. The displacement under 500 N load were 2.596 ± 0.125 mm, 2.344 ± 0.099 mm for Group IIa AP and Group IIa PA. The displacement under 750 N load were 3.997 ± 0.164, 3.386 ± 0.125 mm for Group IIa AP and Group IIa PA. The failure loads were 384 ± 14 N, 415 ± 19 N for Group IIa AP and Group IIa PA. In the type IIa fracture group, the difference was no longer significant (p > 0.001). Therefore, there is a mechanical threshold that ranges from 38.36 to 52.33% between type IIa and type IIb fractures. Conclusions The effect of the nailing direction on the strength of fixation has a fracture-block critical point, which is consistent overall with the trend that the larger the fracture block is, the greater the stability when nailing from anterior to posterior, and the smaller the fracture block is, the greater the strength when nailing from posterior to anterior.

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Locking Plate Alone or in Combination with Cannulated Screws for Hoffa Fractures: A Retrospective Study

Cited by 4 publications

References 26 publications

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Biomechanics of internal fixation in Hoffa fractures – A comparison of four different constructs

The effect of screw orientation on internal fixation of Letenneur type II Hoffa fractures: a biomechanics study

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