The Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa frac...The Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized. The understanding of the mechanism of trauma has become more nuanced. The literature has also evolved to classify the fracture with the purpose of surgical management in mind. This can be used to plan approach and fixation with preservation of blood supply. Classification can also prognosticate the outcomes in Hoffa fracture.展开更多
BACKGROUND Hoffa fracture is rare,especially in adolescents,and has a high rate of complications such as avascular necrosis and osteoarthritis;moreover,there are no definitive guidelines for its treatment.This report ...BACKGROUND Hoffa fracture is rare,especially in adolescents,and has a high rate of complications such as avascular necrosis and osteoarthritis;moreover,there are no definitive guidelines for its treatment.This report could provide a new potential treatment for Hoffa fracture.CASE SUMMARY A 16-year-old girl presented to the orthopedic emergency department of No.2 People’s Hospital of Yibin City with persistent pain following a right knee injury sustained during a sprint race.Her knee was swollen and tender,and the range of motion was restricted by the pain.X-ray and computed tomography revealed a Hoffa fracture in the right knee.After consultation,surgical treatment was performed,and the fracture was fixed with three 3.5-mm cannulated cancellous screws;osteochondral plugs that were harvested from the screw insertion site were re-implanted to cover the screw head.The patient’s fracture and osteochondral plug healed 6 mo postoperatively,and she presented a knee range of motion of 0–135 without pain,and was walking without support with a normal gait.CONCLUSION Here,we describe an innovative surgical procedure for Hoffa fracture that could provide a new possibility for the treatment of similar fractures,and further improve their management.展开更多
BACKGROUND Hoffa’s fracture is a coronal-oriented fracture of the femoral condyle.It is rarely observed in pediatric patients that isolated coronal fracture of the medial femoral condyle accompanies an intact lateral...BACKGROUND Hoffa’s fracture is a coronal-oriented fracture of the femoral condyle.It is rarely observed in pediatric patients that isolated coronal fracture of the medial femoral condyle accompanies an intact lateral femoral condyle.Only a few cases involving Hoffa’s fracture of the medial femoral condyle have been reported in patients with undeveloped skeletons.Such a fracture cannot be observed by routine imaging examinations,thus resulting in possible misdiagnosis and further treatment challenges.CASE SUMMARY A 5-year-old boy with Hoffa’s fracture of the medial femoral condyle suffered from right knee pain and severe swelling after being hit by a heavy object.The patient was misdiagnosed and initially treated in a local primary healthcare center.No improvement in his right knee’s extension was observed following conservative treatment for 2 wk.The patient was transferred to our hospital,rediagnosed using arthroscopy,and underwent open reduction and internal fixation.The therapeutic outcome was satisfactory with the screws removed 7 mo after fixation.At the final follow-up of 40 mo,the range of motion in the knee had recovered.There was no varus-valgus instability.CONCLUSION Hoffa’s fracture is rarely seen in children aged 5 years,let alone in the medial condyle,and can easily be misdiagnosed due to limited physical and imaging examinations.Suspected Hoffa’s fracture in preschool children should be confirmed based on arthroscopic findings.Open reduction and internal fixation should be performed to protect the articular surface and prevent long-term complications.展开更多
文摘The Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized. The understanding of the mechanism of trauma has become more nuanced. The literature has also evolved to classify the fracture with the purpose of surgical management in mind. This can be used to plan approach and fixation with preservation of blood supply. Classification can also prognosticate the outcomes in Hoffa fracture.
文摘BACKGROUND Hoffa fracture is rare,especially in adolescents,and has a high rate of complications such as avascular necrosis and osteoarthritis;moreover,there are no definitive guidelines for its treatment.This report could provide a new potential treatment for Hoffa fracture.CASE SUMMARY A 16-year-old girl presented to the orthopedic emergency department of No.2 People’s Hospital of Yibin City with persistent pain following a right knee injury sustained during a sprint race.Her knee was swollen and tender,and the range of motion was restricted by the pain.X-ray and computed tomography revealed a Hoffa fracture in the right knee.After consultation,surgical treatment was performed,and the fracture was fixed with three 3.5-mm cannulated cancellous screws;osteochondral plugs that were harvested from the screw insertion site were re-implanted to cover the screw head.The patient’s fracture and osteochondral plug healed 6 mo postoperatively,and she presented a knee range of motion of 0–135 without pain,and was walking without support with a normal gait.CONCLUSION Here,we describe an innovative surgical procedure for Hoffa fracture that could provide a new possibility for the treatment of similar fractures,and further improve their management.
文摘BACKGROUND Hoffa’s fracture is a coronal-oriented fracture of the femoral condyle.It is rarely observed in pediatric patients that isolated coronal fracture of the medial femoral condyle accompanies an intact lateral femoral condyle.Only a few cases involving Hoffa’s fracture of the medial femoral condyle have been reported in patients with undeveloped skeletons.Such a fracture cannot be observed by routine imaging examinations,thus resulting in possible misdiagnosis and further treatment challenges.CASE SUMMARY A 5-year-old boy with Hoffa’s fracture of the medial femoral condyle suffered from right knee pain and severe swelling after being hit by a heavy object.The patient was misdiagnosed and initially treated in a local primary healthcare center.No improvement in his right knee’s extension was observed following conservative treatment for 2 wk.The patient was transferred to our hospital,rediagnosed using arthroscopy,and underwent open reduction and internal fixation.The therapeutic outcome was satisfactory with the screws removed 7 mo after fixation.At the final follow-up of 40 mo,the range of motion in the knee had recovered.There was no varus-valgus instability.CONCLUSION Hoffa’s fracture is rarely seen in children aged 5 years,let alone in the medial condyle,and can easily be misdiagnosed due to limited physical and imaging examinations.Suspected Hoffa’s fracture in preschool children should be confirmed based on arthroscopic findings.Open reduction and internal fixation should be performed to protect the articular surface and prevent long-term complications.
