CASE REPORTCruciate fracture of the distal femur: the double Hoffa fracture
Introduction
We describe a comminuted intercondylar fracture of the distal femur that was associated with a coronal split of both condyles, essentially double Hoffa fractures. Initially poorly treated, revisional reconstruction with small fragment screw fixation and the LISS-DF device was performed. The patient regained active knee ROM from 10 to 100° and the fracture had healed after 8 weeks.
Section snippets
Case report
A 20-year-old woman was involved in a 50 mph head on impact in a motor vehicle crash and taken to an outside hospital. Her main injuries were a closed fracture of left femur (AO-OTA 32C), a closed intercondylar fracture of the right femur (AO-OTA 33C2.3) and an open fracture of the right clavicle. There was no neuro-vascular compromise and no head or visceral injury. Following initial resuscitation, her fractures were stabilised operatively three hours after injury. An unreamed left femoral
Discussion
The “Hoffa” fracture is a rare injury where there is a coronal plane fracture in the femoral condyle. This was first described by Friedrich Busch in 1869 and later by Albert Hoffa in 1904.1 There are very few reports in literature describing its management and to our knowledge, no previous report of a complex C type injury with bicondylar Hoffa fractures. Recently Zeebregts et al.4 described a case of unilateral bicondylar fracture of femur but there was no metaphyseal fracture, after screw
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Cited by (21)
The Hoffa fracture: Coronal fracture of the femoral condyle a review of literature
2018, Journal of OrthopaedicsCitation Excerpt :3.5 mm screws were used to reconstruct the fragment antero-posteriorly while the distal articular fragment was reduced using 3.5 mm screws latero-medially. The fracture was then stabilized using the LISS-DF device.19 A unique case-report of a 14-year-old patient who presented with a severe horizontal rotation of the patella combined with a lateral femoral condylar fracture.
Unicondylar fractures of the distal femur
2014, Revue de Chirurgie Orthopedique et TraumatologiqueUnicondylar fractures of the distal femur
2014, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :Only very few cases of malunion have been reported in earlier studies of small numbers of patients. Selection of the approach has a major influence on the ability to achieve stable anatomic reduction [17,19]. The approach must allow not only reduction of the displacement, but also adequate positioning of the fixation material.
Hoffa fracture, eminentia fracture and posterior cruciate ligament damage: An unusual knee injury
2008, Injury ExtraCitation Excerpt :Although usually only one condyle is involved, bilateral and unilateral bicondylar Hoffa fractures have been reported.3,4 A few cases of Hoffa fractures associated with supracondylar-intercondylar femoral fractures have also been described in the literature.1,2,8 Our patient had an eminentia fracture with PCL injury in addition to the rarely seen medial Hoffa fracture, which further complicated the damage.
Hoffa Fracture of the Femoral Condyle
2008, Radiology Case ReportsCitation Excerpt :The remainder of the fractures in each of these two series were treated operatively [1,3]. Hoffa fractures are typically reduced and fixed with anterior-to-posterior oriented cancellous screws [1,3,4,9,10,11]. When there is metaphyseal extension of the fracture, the fixation is supplemented with a lateral buttress plate [10,11].