Surgically treated Hoffa Fractures with poor long-term functional results

Onay, Tolga; Gülabi, Deniz; Çolak, İlker; Bulut, Güven; Gümüştaş, Seyit Ali; Çeçen, Gültekin Sıtkı

doi:10.1016/j.injury.2017.11.026

Cited by 28 publications

(50 citation statements)

References 24 publications

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“…In cadaver studies, Type I and Type III Hoffa fractures have been shown to have soft tissue attachments that provide blood flow to the fracture fragment. However, Type II fractures are completely intra-articular, without any soft tissue attachments making this fracture susceptible to nonunion 5,6 . In our study, the reason why both cases of Hoffa fractures gave rise to nonunion might be that both cases were Type II Hoffa fractures that did not have any soft tissue attachments.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review

Zhang

Tao

et al. 2020

Orthopaedic Surgery

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Background A coronal fracture of the distal femoral condyle, known as a Hoffa fracture, seldom occurs and is easy to misdiagnose. Surgery treatment, including open anatomic reduction and internal fixation, is the primary method of treatment. However, cases involving nonunion are extremely rare. Case Presentation We reported two cases in a 56‐year‐old female who visited our outpatient clinic with complaints of locking sensation, swelling, and pain, and a 64‐year‐old male patient who need additional care after having undergone surgery for a distal femur fracture. They presented with nonunion ofa Hoffa fracture (Letenneur type II), and these cases of nonunion were resolved surgically with debridement, two cannulated lag screws, a lateral extra‐articular buttress plate, and the liberal use of autologous bone grafts. After surgery, the two patients were allowed to bear partial weight and perform exercises. They were allowed to walk with full weight‐bearing after 3 months. No early complications, such as infection and loss of reduction, were noted after the revision surgery. At the one‐year follow‐up, both patients had excellent function and reported minimal pain, with a Lysholm score of 94. Conclusions Our case reports highlight the importance of the liberal use of autologous bone grafts, which allow stable reconstruction of the affected femoral condyle, thereby restoring joint congruence. A lateral extra‐articular buttress plate in combination with two cannulated lag screws is recommended for nonunion in Hoffa fracture patients, and they need to be closely followed up to detect complications promptly, especially those related to nonunion.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review

Zhang

Tao

et al. 2020

Orthopaedic Surgery

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“…In general, popliteal artery injury is seen after high-energy trauma to the knee such as dislocations, complex tibial plateau fractures or supracondylar femur fractures,29 but it may also occur after blunt trauma without a fracture or dislocation 30. It has been assumed that a Hoffa fracture may occur due to direct anteroposterior force to the flexed and abducted knee6 or due to vertical shear with a twisting mechanism 7 8. In this case, the patient was hit from the right side, with direct impact on the right knee.…”

Section: Discussionmentioning

confidence: 99%

“…These so-called Hoffa fractures are rare,1 often resulting from high-energy trauma, such as motor cycle accidents or falls from height,3 4 but also following low-energy trauma such as a fall in elderly patients 5. It has been assumed that a direct anteroposterior force to the flexed and abducted knee results in this specific type of fracture,6 however, vertical shear with a twisting mechanism has been postulated as well 7 8. Hoffa fractures often involve the lateral condyle,8 9 but fractures of the medial3 10 as well as bilateral condyles11 12 are also observed.…”

Section: Introductionmentioning

confidence: 99%

Hoffa fracture accompanied by dissection of the popliteal artery

et al. 2019

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After a high-energy trauma, a 37-year-old motorcyclist presented to the emergency ward with a Hoffa fracture of the lateral femoral condyle of the right knee. Following admission, the patient developed a pale, cold and pulseless right foot. CT angiography scan showed a 5 cm dissection of the popliteal artery. Emergency arterial reconstruction was performed and the Hoffa fracture was repaired in a second stage. To our knowledge, this is the first report of a patient with a Hoffa fracture accompanied by a popliteal artery dissection.

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“…Up to 31% of these rare injuries is overlooked on plain radiographs [ 3 , 5 , 7 , 10 ]. Even though an oblique radiograph may be helpful, a CT scan is generally recommended to accurately identify the coronal fractures [ 5 , 10 - 11 ]. Also, a CT scan is critical for pre-operative planning, with regard to the surgical approach and implant selection [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Corrective Osteotomy for Coronal Plane Malunion of the Medial Femoral Condyle

Ozan

Okur

Ünlü

et al. 2018

Cureus

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Medial femoral condyle malunion in the coronal plane is a very rare injury. In this presented case, we performed intra-articular corrective osteotomy for a malunited medial femoral condyle in the coronal plane of a 22-year-old man and obtained good functional and radiographic results. Corrective osteotomy for a malunited medial Hoffa fracture is technically very challenging, but intra-articular corrective osteotomy for these malunited fractures offers a good outcome and should be considered as a salvage treatment.

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Surgically treated Hoffa Fractures with poor long-term functional results

Cited by 28 publications

References 24 publications

Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review

Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review

Hoffa fracture accompanied by dissection of the popliteal artery

Corrective Osteotomy for Coronal Plane Malunion of the Medial Femoral Condyle

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