[93] The biggest challenge in the treatment of Hoffa fractures under arthroscopy due to the patella is dissecting the fragments for reduction[94] and placing screws perpendicularly into the fracture line. 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Some error has occurred while processing your request. [24]. Biau DJ, Schranz PJ. Medicine101(50):e32104, December 16, 2022. modify the keyword list to augment your search. 2012;40:191623. Lateral femoral condyle osteochondral fracture combined to patellar We do not do patellar medial collateral ligament repair to reduce complications such as knee joint adhesion. Surgical diagrams (A: osteochondral fracture of the lateral femoral condyle; B: fixation of fracture block with Kirschner wire; C: fixation of fracture block with anchor; D: preparation of bone tunnel; E: penetration of PDS line and PDS guidance of anchor suture to the outer entrance of femoral tunnel; F: Operation completion diagram). A modified posterolateral approach for. [ 21] Matthewson et al [ 21] reported for the first time that patellar dislocation complicated with OCF of LFC was treated with early Hoffa fractures are caused by shear stress between the femoral condyle and tibial plateau. Arthrosc Tech 2015;4:e299303. Hoffa nonunion, two cases treated with headless compression screws. The site is secure. Screw pullout strength: a biomechanical comparison of large-fragment and small-fragment fixation in the tibial plateau. [75]. [72]. The authors have no funding and conflicts of interest to disclose. Arthroscopy 2012;28:13817. The treatment options for OCF of LFC include: loose body removal, microfracture, open reduction and internal fixation, cartilage transplantation, autologous or allogeneic osteochondral transplantation, etc. The patient's treatment plan included 6 weeks of weight bearing as tolerated for the left lower extremity while wearing a knee brace that prevented the final 20 of knee extension, and a program of range-of-motion and progressive resistive exercises, with eventual emphasis on sport-specific activities. Lateral-view radiograph of the left knee demonstrating an abnormally deep depression of the medial condylopatellar sulcus (arrow). Repair of displaced partial articular fracture of the distal femur: the. Background The goal of this present study was to precisely determine the dimension and location of the impaction fracture on the lateral femoral condyle in patients with an ACL rupture. A patella that is stuck between the tibia and femur can be relocated naturally by flexing of the hip joint with the knee in 110 of flexion under local anesthesia. J Pediatr Orthop. Low-energy trauma can cause Hoffa fractures in people with skeletal immaturity[24] as well as in those with low bone mass, such as patients with osteoporosis. The distal femur is where the bone flares out like an upside-down funnel. ;Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. [21]. Postoperative reexamination of computed tomography scan showed that the bone block was well reduced. Arastu MH, Kokke MC, Duffy PJ, et al. Mashoof AA, Scholl MD, Lahav A, et al. Nondisplaced Hoffa fractures can be treated with cylindrical plaster cast immobilization with the knee in 10 of flexion. Paa L, Vesel R, Koi J, et al. [96]. The main cause of a Hoffa fracture is a high-energy injury such as those sustained in traffic collisions (80.5% of cases) and falls (9.1% of cases). Anatomic reduction of the articular surface, stable fixation, and early mobilization should be the aims of treatment. This is the first case to apply the suture anchor system to the reduction and fixation of fracture. Bali K, Mootha AK, Krishnan V, et al. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. Acta Orthop Traumatol Turc. The most common way to fracture the femoral condyles is jumping from a large height. Wu, Liang MMa; Liu, Chao BMb; Jiang, Bing BMc; He, Lijiang MMd,*, a Department of Orthopedic Surgery, First Peoples Hospital of Linpin District, Hangzhou, Zhejiang, China, b Department of General Surgery, Medicine Faculty of Universitas Prima Indonesia, North Sumatra, Indonesia, c Department of General Surgery, Daocheng Country Peoples Hospital, Sichuan, China. An appropriate surgical approach allowing full fracture exposure is selected based on fracture type. [53]. Type I, the most common classification, is a vertical fracture line parallel to the posterior cortex of the femur and involves the entire condyle. Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. Liebergall M, Wilber JH, Mosheiff R, et al. Furthermore, a Hoffa fracture is associated with cruciate ligament injury. [4]. Plain radiograph Osteochondral fractures of the lateral. Knee Surg Sports Traumatol Arthrosc. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. Distal Femur Fractures - Trauma - Orthobullets Ji G, Wang S, Wang X, et al. The appropriate surgical plan is chosen based on the location of the Hoffa fracture, characteristics of the fracture line, fracture severity, and associated injuries. Wang JY, Liu Y, Li Y, et al. Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. Two patients with osteochondral injury of the weight-bearing portion of the lateral. Incarcerated patellar tendon in. Letenneur J, Labour PE, Rogez JM, et al. [48]. [61]. impacted and stress fractures. Bone contusion and associated meniscal and medial collateral - PubMed After arthroscopic confirmation of Lateral Femoral Condyle (LFC) ostechondral fracture (HSL, Hill-Sachs-like Lesion) the anterolateral portal is enlarged to 2-3 cm. This approach can also be used to treat comminuted fractures or complex Hoffa fractures.[18].

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