IntroductionHoffa fractures are rare and difficult to treat for orthopaedic surgeons. The mechanism of injury of Hoffa fracture is still unknown and the operation approch and fixation method are still controversial. The aim of this study is to compare the clinical effect between two fixation methods on Hoffa fractures.Case descriptionFrom April 2004 to July 2013, we treated eleven patients (new method group) with Hoffa fracture using the new fixation method (fixed with intercondylar screw and crossed screws) and sixteen patients (traditional method group) using the traditional fixation method (fixed with anteroposteriorly placed screws). All documents from their admission until the last followup in December 2015 were reviewed, data regarding complications collected and results were evaluated using the Knee Society Score.Discussion and EvaluationAfter an average follow-up period of 27.1 months (range 24–32 months), all fractures had healed. The average healing time of the new method group was 11.36 weeks (range 9–14 weeks) and the average healing time of the traditional method group was 11.88 weeks (range 9–14 weeks). According to the Knee Society Score, the average score of the new method group was 176.36 points (range 125–199 points), and the average score of the traditional method group was 171.19 points (range 148–197 points). Statistical analysis (t test, t = 0.76, P > 0.05) showed that the difference of both the healing time (t test, t = 0.94, P > 0.05) and the score between these two groups was not significant.ConclusionsThese results indicate that the new fixation method for Hoffa fracture is as effective as the traditional method and may provide a new way to treat Hoffa fractures.

Context Observational studies have suggested associations between adipokines and cardiovascular disease (CVD), but the roles of certain adipokines remain controversial, and these associations have not yet been ascertained causally. Objective To investigate whether circulating adipokines causally affect the risk of CVD using two-sample Mendelian randomization (MR). Methods Independent genetic variants strongly associated with adiponectin, resistin, chemerin and retinol binding protein 4 (RBP4) were selected from public genome-wide association studies. Summary-level statistics for CVD, including coronary artery disease (CAD), myocardial infarction, atrial fibrillation (AF), heart failure (HF), stroke and its subtypes were collected. The inverse-variance weighted and Wald ratio methods were used for the MR estimates. The MR-PRESSO, weighted median, MR-Egger, leave-one-out analysis, MR Steiger and colocalization analysis were used in the sensitivity analysis. Results Genetically predicted resistin levels were positively associated with AF risk (OR 1.09; 95% CI, 1.04 to 1.13; P = 4.1×10 -5), which was attenuated to null after adjusting for blood pressure. We observed suggestive associations between higher genetically predicted chemerin levels and an increased risk of CAD (OR 1.27; 95% CI, 1.01 to 1.60; P = 0.040), higher genetically predicted RBP4 levels and an increased risk of HF (OR 1.14; 95% CI, 1.02 to 1.27; P = 0.024). There was no causal association between genetically predicted adiponectin levels and CVD risk. Conclusions Our findings reveal the causal association between resistin and AF, probably acting through blood pressure, and suggest potential causal associations between chemerin and CAD, RBP4 and HF.

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The new fixation method for Hoffa fracture is effective, and may provide a new way to treat Hoffa fractures.