Hoffa’s Fracture with Associated Injuries Around the Knee Joint: An Approach to a Rare Injury

Pathak, Subodh Kumar; Salunke, Abhijeet Ashok; Karn, Shailesh; Ratna, Harish V K; Thivari, Praveen; Sharma, Satyavan; Jena, Sabyasachi

doi:10.7759/cureus.7865

Cited by 10 publications

(23 citation statements)

References 21 publications

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“…It seems to be the rst paper that presented the tibial side PCL bony avulsion accompanying lateral condyle Hoffa fracture. In a recent comprehensive review, literature was searched for Hoffa's fracture and associated injuries around the knee joint, and 11 of 187 papers were selected as eligible for the study, and none of the studies reported an injury similar to our case [7]. Only one case was reported as a PCL injury, not the PCL bony avulsion, by Ocguder et al [6], and their case was presented as tibial eminentia fracture with PCL injury from femoral side attachment associated with medial condyle Hoffa fracture.…”

Section: Discussionmentioning

confidence: 99%

An Uncommon Trauma: Hoffa's Fracture Associated with Tibial Avulsion Fracture of the Posterior Cruciate Ligament

Cengiz¹,

Karaoğlu²

2021

Preprint

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BackgroundSince Hoffa fractures are usually the result of high-energy injuries, many additional accompanying injuries have been described. This is the first paper representing the lateral condyle Hoffa fracture accompanying tibial avulsion fracture of the posterior cruciate ligament (PCL).Case PresentationA 42-years-old male presented with swelling and instability in his left knee after falling during parachute landing. He was diagnosed with simultaneous Letenneur Type I lateral condyle Hoffa fracture and tibial avulsion fracture of the PCL. He was operated on with a single posterior incision for both fractures. Multiple cannulated lag screws were used for the fixation of the Hoffa fracture, and a buttress plate was used for additional stability. PCL avulsion fracture was fixed with a cannulated screw with a washer. The patient was allowed for full-weight-bearing and range of motion at the sixth week after the operation. No complications occurred during follow-up.ConclusionCare should be taken in terms of additional injuries that may accompany Hoffa fractures. The posterior approach allows easy access to both fractures with a single incision. Using a buttress plate after the fixation of the Hoffa fracture with multiple lag screws provides additional stability.

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Section: Discussionmentioning

confidence: 99%

An Uncommon Trauma: Hoffa's Fracture Associated with Tibial Avulsion Fracture of the Posterior Cruciate Ligament

Cengiz¹,

Karaoğlu²

2021

Preprint

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“…Proper diagnosis and fixation are critical to the management of Hoffa fractures as they are commonly associated with nonunion, arthrofibrosis, and osteoarthritis. [ 32 , 34 ]…”

Section: Discussionmentioning

confidence: 99%

Do intra-articular knee injuries detected by preoperative MRI affect the clinical management of extensor mechanism ruptures?

Turner

Akoh

Hetzel

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives: We sought to determine the prevalence of intra-articular findings at the time of extensor mechanism injury that required subsequent surgical intervention. Design: Retrospective cohort study. Setting: Level 1 academic trauma center. Patients/participants: Sixty-seven knees in 66 nonconsecutive patients (mean age 53.6 years, 95.6% male) with extensor mechanism injury and preoperative magnetic resonance imaging (MRI) before undergoing open primary surgical repair. Main outcome measurements: Patellar or quadriceps tendon rupture, high or low injury energy level, and age above or below 45 years were used to stratify patients. The primary outcome was additional surgery for intra-articular injury. Demographics, comorbidities, mechanism and location of injury, and internal derangements based on MRI findings were also collected. Results: Fifty-one knees (76.1%) had quadriceps tendon injury, 13 knees (19.4%) had patellar tendon injury, and 3 knees (4.6%) had both. Thirty-four knees (50.7%) had intra-articular pathology and 3 (4.5%) required additional surgery, including 1 knee (7.7%) with patellar tendon injury and 2 knees (3.9%) with quadriceps tendon injury. Patellar tendon injuries were more commonly associated with cruciate ligament injury ( P < .01) and occurred in younger patients ( P < .001) than quadriceps tendon injury. Conclusions: 50.7% of cases with extensor mechanism injury had intra-articular pathology but only 4.5% required additional surgery. The results of our study suggest that preoperative MRI is unlikely to be of significant clinical utility in most extensor mechanism injuries but should be considered in cases of patellar tendon rupture in younger patients where the incidence of concomitant cruciate ligament injury is higher. Level of evidence: Diagnostic Level III.

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“…The role of the knee joint was evaluated using the Letenneur standard [ 2 ]. Taking into account the range of movement, stability, pain, and assisted walking of the knee joint, the results were divided into four categories.…”

Section: Methodsmentioning

confidence: 99%

Treatment of the Hoffa fracture of the lateral femoral condyle with cannulated screws in combination with an anti-gliding steel plate, a retrospective observational study

Huang

Wang

et al. 2022

BMC Surg

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Background The stability of the Hoffa fracture fixed with a cannulated screw is limited. In the present work, we adopted two cannulated screws from anterior to posterior and posteriorly anti-gliding plate to treat 12 cases with Hoffa fracture of the lateral femoral condyle. Methods Open reduction and internal fixation were performed in 12 patients with Hoffa fractures of the lateral femoral condyle. The Hoffa fracture end was fixed with an anti-gliding steel plate based on cannulated screw fixation in the rear of the distal femur. All patients were followed for 12–24 months, with a median of 15.3 ± 4.6 months. Results All fractures were bony union, with a healing time of 3–6 months (median, 4.5 months). The Letenneur evaluation system was used to assess efficacy. Four indexes were observed, including knee range of motion (ROM), stability, pain, and dependent ambulation. The results revealed that eight cases were excellent and four cases good, with a good rate of 100%. Conclusion The surgical treatment with cannulated screws in combination with an anti-gliding steel plate could fix the end of the Hoffa fracture, which could acquire strong internal fixation and a good curative effect.

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Hoffa’s Fracture with Associated Injuries Around the Knee Joint: An Approach to a Rare Injury

Cited by 10 publications

References 21 publications

An Uncommon Trauma: Hoffa's Fracture Associated with Tibial Avulsion Fracture of the Posterior Cruciate Ligament

An Uncommon Trauma: Hoffa's Fracture Associated with Tibial Avulsion Fracture of the Posterior Cruciate Ligament

Do intra-articular knee injuries detected by preoperative MRI affect the clinical management of extensor mechanism ruptures?

Treatment of the Hoffa fracture of the lateral femoral condyle with cannulated screws in combination with an anti-gliding steel plate, a retrospective observational study

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