Surgical treatment and rehabilitation of medial Hoffa fracture fixed by locking plate and additional screws: A retrospective cohort study

Gao, Mingjie; Tao, Jie; Zhou, Zun-Qiang; Liu, Qingbin; Du, Lin; Shi, Jieming

doi:10.1016/j.ijsu.2015.05.027

Cited by 26 publications

(53 citation statements)

References 20 publications

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“…Do not present, so far, a pseudoarthrosis percentage [2]. 2 Hoffa fracture is classified into three types by Letenneur [6]:…”

Section: Discussionmentioning

confidence: 99%

“…Often missed on plain radiographs but easily found on a CT scan, helping the preoperative planning [1,[4][5][6][7][8]. Up to 25-30% of coronal plane fractures can be missed on plain radiographs [5,7].…”

Section: Discussionmentioning

confidence: 99%

“…The physician should always look for associated injuries of the pelvis, hip, patela and tibial plateau fractures, popliteal vessel injuries and ligamentous disruptions of the knee [7] magnetic resonance imaging is useful for this search [6].…”

Section: Discussionmentioning

confidence: 99%

“…The association of Hoffa fracture and proximal tibial fractures is even rarer [5]. It is an intraarticular fracture of the posterior aspect of the femoral condyle in coronal plane, resulting from high-energy traumas -motor vehicle accidents (most common) or a fall from a height [1,4,6]. Inherently unstable, due to bone instability as well as the pull of the gastrocnemius and popliteus [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…The exact mechanism of this injury is unknown [1,5,6], but it has been postulated that the mechanism of injury is axial compression to the knee with transmission of the ground reaction force through the tibial plateau to the femoral condyles -in a flexed position the posterior portion of the lateral condyle is the leading part of the knee receiving the impact [3].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Isolated Hoffa Fracture - An Unusual and Commonly Forgotten Fracture

Duarte¹,

Silva²,

Fern³

et al. 2018

MOJOR

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“…Do not present, so far, a pseudoarthrosis percentage [2]. 2 Hoffa fracture is classified into three types by Letenneur [6]:…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Isolated Hoffa Fracture - An Unusual and Commonly Forgotten Fracture

Duarte¹,

Silva²,

Fern³

et al. 2018

MOJOR

View full text Add to dashboard Cite

Relationships between Hoffa fragment size and surgical approach selection: a cadaveric study

Orapiriyakul

Apivatthakakul

Phornphutkul

2018

Arch Orthop Trauma Surg

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When the Hoffa fragment is less than 18.3% of the AP diameter of medial condyle or 10.1% of lateral condyle, the fracture is invisible with the PPA. When the Hoffa fragment is more than 28.7% of the medial condyle or 19.9% of the lateral condyle, the PPA should be selected. If the Hoffa fragment is less than 28.7% of the medial condyle or 19.9% of the lateral condyle, the DMA or PLA with posterior-to-anterior screws is recommended. Combined approaches should be considered in some complex cases with articular comminution.

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Hoffa fractures are associated with concomitant soft tissue injures and a high postoperative complication rate

Neumann-Langen,

Eggeling,

Glaab

et al. 2023

Arch Orthop Trauma Surg

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Introduction Hoffa fractures are a rare and often overlooked entity. The main goal of surgical treatment is to restore the articular surface and maintain knee function. However, current clinical data indicate heterogeneous outcomes. The aim of this multicenter study was to obtain a representative data set of patients with isolated Hoffa fractures with special emphasis on concomitant soft tissue injuries, diagnostic algorithms, treatment strategies and functional outcomes. Materials and methods Participating Level I trauma centres were asked to review their internal database for isolated Hoffa fractures treated surgically between 2010 and 2020. Demographics, mechanism of injury, diagnostic and therapeutic algorithm, Letenneur classification, concomitant soft tissue injuries, and postoperative knee function and complications were analysed. Results A total of 56 patients from six participating trauma centres were included. The median age at injury was 45 years (15–94) with a median follow-up of 19 months (2–108). The most common mechanism of injury was high-energy trauma, with unicondylar lateral Letenneur type I and II fractures being the most common. Surgical treatment was independent of the type of fracture and included isolated screw fixation, combined plate and screw fixation and isolated plate osteosynthesis. Isolated screw fixation resulted in significantly better range of motion (ROM) values (p = 0.032), but the highest number of postoperative complications (n = 14/20, n.s.) compared to the other fixation techniques. The highest number of fixation failures requiring revision was observed in the plate and screw fixation group (n = 3/8, p = 0.008). Osteochondral flake fractures (n = 12/43, 27%) and lateral meniscus injuries (n = 5/49, 10%) were commonly seen in Hoffa fractures. Conclusions Treatment of Hoffa fractures with screw fixation resulted in significantly better functional outcomes, probably due to less comminuted fractures. Concomitant cartilage, meniscal and ligamentous injuries are common and warrant preoperative recognition and management.

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Surgical treatment and rehabilitation of medial Hoffa fracture fixed by locking plate and additional screws: A retrospective cohort study

Abstract: Fixation with a locking plate and cannulated or lag screws for medial Hoffa fracture seemed to be effective and reliable for achieving anatomical reduction, and gave satisfactory functional results when coupled with aggressive rehabilitation.

Cited by 26 publications

References 20 publications

Isolated Hoffa Fracture - An Unusual and Commonly Forgotten Fracture

Isolated Hoffa Fracture - An Unusual and Commonly Forgotten Fracture

Relationships between Hoffa fragment size and surgical approach selection: a cadaveric study

Hoffa fractures are associated with concomitant soft tissue injures and a high postoperative complication rate

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