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
Aim:The anatomical study and clinical application for the vascularized corticoperiosteal fl ap from the medial femoral condyle have been performed and described previously.Although prior studies have described the com...Aim:The anatomical study and clinical application for the vascularized corticoperiosteal fl ap from the medial femoral condyle have been performed and described previously.Although prior studies have described the composite osteomyocutaneous fl ap from the medial femoral condyle,a detailed analysis of the vascularity of this region has not yet been fully evaluated.Methods:This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens.Results:The descending genicular artery(DGA)was found in 33 of 40 cases(82.5%).The superomedial genicular artery(SGA)was present in 10 cases(25%).All 33 cases(100%)of the DGA had articular branches to the periosteum of the medial femoral condyle.Muscular branches and saphenous branches of the DGA were present in 25 cases(62.5%)and 26 cases(70.3%),respectively.Conclusion:The current study demonstrates that the size and length of the vessels to the medial femoral condyle are suffi cient for a vascularized bone fl ap.A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous fl ap from the medial femoral condyle,because of the considerable anatomical variations in different branches of the DGA.展开更多
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.
文摘Aim:The anatomical study and clinical application for the vascularized corticoperiosteal fl ap from the medial femoral condyle have been performed and described previously.Although prior studies have described the composite osteomyocutaneous fl ap from the medial femoral condyle,a detailed analysis of the vascularity of this region has not yet been fully evaluated.Methods:This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens.Results:The descending genicular artery(DGA)was found in 33 of 40 cases(82.5%).The superomedial genicular artery(SGA)was present in 10 cases(25%).All 33 cases(100%)of the DGA had articular branches to the periosteum of the medial femoral condyle.Muscular branches and saphenous branches of the DGA were present in 25 cases(62.5%)and 26 cases(70.3%),respectively.Conclusion:The current study demonstrates that the size and length of the vessels to the medial femoral condyle are suffi cient for a vascularized bone fl ap.A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous fl ap from the medial femoral condyle,because of the considerable anatomical variations in different branches of the DGA.
