2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. Acta Chir Orthop Traumatol Cech. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. [94]. Unauthorized use of these marks is strictly prohibited. Conjoint bicondylar, [45]. A patient, 15-year-old, female student. [23]. For example, a fracture line dividing the femoral condyle surface into 2 parts is classified as type I; 2 fracture lines dividing the femoral condyle surface into 3 parts is type II; and 3 or more fracture lines dividing the femoral condyle surface into 4 or more parts is type III. Impaction Fracture of the Medial Femoral Condyle assessment of the anterior cruciate liga- ment with the anterior drawer and Lach- man tests was negative for laxity. According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis. In these fractures, the popliteus tendon and the lateral head of the gastrocnemius muscle remain attached to the fragment. A mechanical evaluation of two fixation methods using cancellous screws for coronal fractures of the lateral condyle of the distal femur (OTA type 33B). Improving the accuracy and timeliness of Hoffa fracture diagnosis and improving minimally invasive treatment outcomes remain the focus of orthopedic surgeons. Intertrochanteric femoral fractures occur mostly in the elderly, and the average age of onset is 66-76 years. Valgus strain on the knee and the continuous pull of the quadriceps causes the patella to ride against the femoral condyle, resulting in rotation around its vertical axis. Among the various types of Hoffa fractures, the Letenneur II is unique because the fragments are small and difficult to fix, and poor blood supply to the fragments impairs its healing. Injury 2005;36:8625. J Knee Surg 2008;21:23540. As the knee is being extended and in full extension, it can be seen that femoral and tibial surfaces do not articulate with each other. Cruciate fracture of the distal femur: the double. Apropos of 128 cases]. [13] There are also many reports on OCF in non-weight-bearing area of LFC. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. [53]. The distal femur is the area of the leg just above the knee joint. [17]. In this paper, three cases of osteochondral fracture of lateral femoral condyle were treated with arthroscopic TWINFIX Ti suture anchor internal fixation, and good results were obtained. Efficacy of multiple Acutrak hollow head compression screws in the, [68]. Wang JY, Liu Y, Li Y, et al. (B) 1.5cm1.5cm free bone was found in the knee joint cavity, and the bone fracture was intact. The plate fit the bone surface well, despite some bending, the clinical and radiological outcomes were good. [76,77] Fixation with 2 or more screws can prevent rotation and rotational displacement. Lewis SL, Pozo JL, Muirhead-Allwood WF. If radiographic findings are negative in questionable cases, CT and magnetic resonance imaging (MRI) should be performed. [57]. (B) BULLET fixed at the entrance of the lateral bone canal of the distal femur. [20]. [74]. doi: 10.1097/MD.0000000000032104. Knee flexion angle is more important than guidewire type in preventing posterior femoral cortex blowout: a cadaveric study. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. absorbable internal fixation; dislocation of patella; femoral condyle; osteochondral fracture. [15,16] These forces cause gross displacement of the condyle, which can not only rupture the quadriceps tendon but also perforate the skin, resulting in an open injury. Two cartilage masses can be seen during the operation. FOIA to maintaining your privacy and will not share your personal information without [89]. Intra-articular corrective osteotomy for malunited. [18]. chauffeur fracture: intraarticular fracture involving radial styloid; Another type of distal radius fracture is the Lister's tubercle fracture. Matthewson MH, Dandy DJ. Li WH, Li Y, Wang MY. Ann Chir 1978;32:2139. 2018 Oct;21(5):308-310. doi: 10.1016/j.cjtee.2018.08.004. Jain A, Agrawal P, Chadha M, et al. Zhou S, Cai M, Huang K. Treatment of. White EA, Matcuk GR, Schein A, et al. Khle J, Angele P, Balcarek P, et al. Highlight selected keywords in the article text. Here, we summarized the injury mechanism, diagnosis, classification, and treatment options of Hoffa fractures. [ 21] Matthewson et al [ 21] reported for the first time that patellar dislocation complicated with OCF of LFC was treated with early Two patients with osteochondral injury of the weight-bearing portion of the lateral. Am J Sports Med. Your message has been successfully sent to your colleague. Surgical treatment of femoral medial condyle fracture with lag screws J Orthop Trauma 2006;20:2736. [90]. The patellar height was in the normal range (Caton-Deschamp index 1.0). [7] Nondisplaced Hoffa fractures are difficult to visualize on anterior and lateral radiographs of the knee. Goel A, Sabat D, Agrawal P. Arthroscopic-assisted fixation of, [13]. According to the severity of Hoffa fracture and combined injuries, a reasonable treatment plan can be developed. Seeley MA, Knesek M, Vanderhave KL. Distal pulses and sensation were intact. J Pediatr Orthop. 2017;84:4417. J Bone Joint Surg Am 2006;88:22704. What is an Impact Fracture? - Definition from Corrosionpedia In the type II (bicondylar Hoffa fracture), both condyles are fixed with anteroposterior screws. Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. 2018;31:38291. 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). [9] The pain due to these combined injuries often exceeds that caused by the Hoffa fracture, which can lead physicians to miss the latter. The use of several 3.5-mm-diameter screws is recommended to fix the fractures. Bilateral. Impact fractures are due to track formation and propagation. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. The work cannot be changed in any way or used commercially without permission from the journal. Nondisplaced fractures can be managed conservatively; however, they involve a high risk of redisplacement. The bone mass is missing at the fracture. The typical MRI findings after transient lateral dislocation of the patella have been well described and include a bone contusion pattern involving the inferomedial pole of the patella and the anterolateral aspect of the nonarticular portion of the lateral femoral condyle. An official website of the United States government. [101]. Acta Orthop Traumatol Turc 2014;48:3837. [84]. Chin J Traumatol. [16]. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. Atesok K, Doral MN, Whipple T, et al. Rofo. [92]. [100,101] To avoid damaging the cartilage in these cases, it is important to reduce the patella early and restore the patellofemoral joint stability by repairing the damaged medial soft tissues. Transverse Hoffas or deep. [42] Compared with anteroposterior and lateral films, oblique radiographic views can show minimally displaced fractures better[14] and can, therefore, be used as a routine examination method for a Hoffa fracture. and transmitted securely. http://creativecommons.org/licenses/by-nc-nd/4.0. 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. Injury 2018;49:398403. [42]. Osteochondral defects of LFC are usually caused by lateral patellar dislocation, most of which are located on the medial side of patella. Kapoor C, Merh A, Shah M, et al. [95]. [24]. Nonunion of a, [62]. Paa L, Vesel R, Koi J, et al. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. Hoffa fractures are most commonly caused by traffic accidents, especially motorcycle accidents. Federal government websites often end in .gov or .mil. The Letenneur classification, computed tomography (CT) classification, the AO classification, and the AO classification with supplement are widely used in clinics to categorize Hoffa fractures. Management of any globe injury generally takes precedence over fractures 1. -, Enea D, Busilacchi A, Cecconi S, Gigante A. Latediagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report. Introduction. Cureus 2016;8:e802. After 6 months, the patient could resume normal sporting activities, and the knee joint extension and flexion were normal without knee instability and pain. Cartilage. Epub 2018 Oct 4. Sasidharan B, Shetty S, Philip S, et al. 1). Epub 2007 Mar 23. 2022 Dec 16;101(50):e32104. Guo H, Chen Z, Wei Y, Chen B, Sun N, Liu Y, Zeng C. Orthop Surg. High-energy trauma is a common cause of a Hoffa fracture, although low-energy trauma and iatrogenic injury can also lead to these fractures. Heuschen UA, Gohring U, Meeder PJ. You may be trying to access this site from a secured browser on the server. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. Highlight selected keywords in the article text. The patient had an uneventful postoperative recovery. [104] To prevent habitual patellar dislocation, repair of the medial retinaculum complex or a combination of lateral retinacular release[14,105] and simultaneous patellar ligament insertion on the tibial tubercle is recommended. Surgical versus nonsurgical treatments of acute primary patellar dislocation with special emphasis on the MPFL injury patterns. [4]. [56]. [20]. An unusual fracture of the lateral femoral condyle in a child. Appointments 216.444.2606. Viskontas DG, Nork SE, Barei DP, et al. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. Westmoreland GL, McLaurin TM, Hutton WC. 5cm cartilage mass was stripped from nonweight-bearing area of the LFC, and no osteochondral mass was found at the medial edge of patella (Fig. 2007 Oct;23(10):1133.e1-4. [96]. 2013;33:5118. [51]. [5]. This method is beneficial for reducing small and rotating fragments. 1). 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. modify the keyword list to augment your search. lateral femoral condyle fractures in 80% Angiography indications ankle-brachial index (ABI) <0.9 obvious signs of vascular injury i.e., hard and soft signs (pulselessness, rapidly expanding hematoma, massive bleeding, etc.) Making the diagnosis of a Hoffa fracture is challenging. During complete anterior cruciate ligament (ACL) tears in pivoting mechanisms, the area of the lateral femoral condyle (LFC) localized just above the anterior third of the lateral meniscus (LM) impacts the posterior border of the lateral tibial plateau (LTP), which may result in a subchondral compression fracture. Weight bearing is allowed with radiographic evidence of healing, which usually occurs by 10 weeks of the postoperative period.[55]. 2001;17:5425. Pathology. Get new journal Tables of Contents sent right to your email inbox, http://creativecommons.org/licenses/by-nc-nd/4.0, Hoffa fracture of the femoral condyle: Injury mechanism, classification, diagnosis, and treatment, Articles in Google Scholar by Yabin Zhou, MD, Other articles in this journal by Yabin Zhou, MD, Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A meta-analysis of randomized controlled trails, Hoffa fracture combined with rotational dislocation of the knee joint: A novel case report, PET/CT-negative malignant spine tumor with pathologic fracture: A case report of malignant solitary bone plasmacytoma, Prognostic factors to survival of patients with chondroblastic osteosarcoma, Ankle joint dislocation treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis, Privacy Policy (Updated December 15, 2022). In these cases, the associated patellar fracture results from a combination of forces: direct trauma causing the Hoffa fracture and possible indirect injuries from sudden contraction of the quadriceps muscle causing a vertical patellar fracture.[23]. (A) The fresh 1.5cm1.5cm fracture surface of the lateral condyle of femur was found under arthroscopy. At present, open reduction is often used to treat osteochondral fractures. 2017;30:37884. [53,91] However, some Hoffa fractures combined with a tear of the posterolateral horn of the lateral meniscus are identified intraoperatively, and tear of the lateral meniscus can be repaired with suture anchors. modify the keyword list to augment your search. Technique for Treatment of Subchondral Compression Fracture of the When the patient was sent to the emergency room, the right knee swelled obviously, tenderness over the medial border of the patella, the apprehension test was positive, lateral stress test was negative, and the knee range of motion:F/E 90/0. Knee flexion was limited less than 60 within 8 weeks after operation, partial weight-bearing was allowed at 8 weeks, followed by full weight bearing from 12 weeks after operation. Lateral Femoral Condyle (LFC) osteochondral fracture (HSL, Hill-Sachs-like Lesion) can be seen in 30 of knee flexion. [65]. Jain A, Aggarwal P, Pankaj A. Concomitant ipsilateral proximal tibia and femoral Hoffa fractures. 2020 Jun 15;9 (6):e823-e828. [17,18] Magnetic resonance imaging (MRI) should be performed when injury is suspected to the meniscus, cruciate ligament, collateral ligament, or other soft tissues to determine the extent of injury,[32] develop appropriate surgical plans, and accurately assess prognosis. Caton J, Deschamps G, Chambat P, et al. Bethesda, MD 20894, Web Policies Disclaimer. [10] Werner and Miller[11] reported that iatrogenic injury is a cause of Hoffa fracture that cannot be ignored. Dejour H, Walch G, Nove-Josserand L, et al. Correspondence: Wei Chen, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050051, China (e-mail: [emailprotected]).