CT examination 6months after operation: one screw internal fixation, regular external condyle cortex, good alignment at the end of fracture, callus growth and unclear fracture line could be seen in the right lateral femoral condyle. An attempt to treat Hoffa fractures under arthroscopy: A case report. Neglected. After operation, the fracture of femoral condyle healed well and the function of knee joint recovered gradually. Letenneur J, Labour PE, Rogez JM, et al. A radiographic examination should include anteroposterior, lateral, oblique, and stress views of the knee. A meta-analysis by Khle et al[6] show that there is no unified treatment for osteochondral fractures (OCF) of knee joint at present, and the overall failure rate is 17%. Li et al[25] used absorbable suture to treat OCF caused by patellar dislocation and achieved good medium-term results. [76,77] Fixation with 2 or more screws can prevent rotation and rotational displacement. Three types of fracture are defined based on the coronal fracture line (Fig. Partial ceramic crowns: influence of ceramic thickness, preparation design and luting material on fracture resistance and marginal integrity in vitro. Impaction Fracture of the Medial Femoral Condyle Chin J Orthop Trauma 2009;9:8503. Intra-articular corrective osteotomy for malunited. Fracture of the Lateral Femoral Condyle | Journal of Orthopaedic Transverse Hoffas or deep. Am J Sports Med. Khle J, Angele P, Balcarek P, et al. [74]. [14]. The Authors. In addition to changes in bone mineral composition and a reduced proportion of bone matrix in patients with osteoporosis, changes in bone microstructure, thinning of bone cortex, and reduction in the number and size of bone trabeculae result in a decreased bone load capacity[26] and an increased risk of a Hoffa fracture with low-energy trauma. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. [95] Because Hoffa fractures are intra-articular, the success of anatomical reduction and firm internal fixation is closely related to postoperative complications like traumatic arthritis. Medicine (Baltimore). In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. 2). Acta Orthop Traumatol Turc. Correspondence: Wei Chen, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050051, China (e-mail: [emailprotected]). Musculoskelet Surg 2012;96:4954. Primary traumatic patellar dislocation. [79]. Bone contusion and associated meniscal and medial collateral - PubMed Knee flexion angle is more important than guidewire type in preventing posterior femoral cortex blowout: a cadaveric study. The bone mass is missing at the fracture. [43]. Nondisplaced fractures can be managed conservatively; however, they involve a high risk of redisplacement. A review of 23 patients. The Letenneur classification[31] divides fractures into 3 types (Fig. The funding sources have no role in study design, literature collection, review, data analysis, and manuscript preparation. The patellar height was in the normal range (Caton-Deschamp index 1.0). The authors have no conflicts of interest to disclose. Tan et al[75] recommended an improved posterolateral approach starting from the space between the peroneal nerve and the biceps femoris. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. 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. In the type II (bicondylar Hoffa fracture), both condyles are fixed with anteroposterior screws. Singh R, Singh RB, Mahendra M. Functional outcome of isolated Hoffa fractures treated with cannulated cancellous screw. 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). Arthroscopic; Internal fixation; Osteochondral fracture; Suture anchor; TWINFIX Ti. See this image and copyright information in PMC. The tears of the lateral meniscus and medial meniscus were detected during arthroscopy. Chin J Traumatol 2011;14:1436. Injury 2005;36:8625. Open reduction and internal fixation are preferred. d Department of Orthopedic Surgery, Second Peoples Hospital of Yuhang District, Hangzhou, Zhejiang, China. Unfallchirurg 2004;107:1521. Emerg Radiol 2015;22:3378. Callewier et al[23] reported a patient who used absorbable pin fixation to treat OCF in the weight-bearing area of LFC. Osteochondral Fracture Lateral Femoral Condyle Treated with - Hindawi Osteochondral defect | Radiology Reference Article | Radiopaedia.org official website and that any information you provide is encrypted The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request. Please try again soon. Potini VC, Gehrmann RM. Treatment options include loose body removal, microfracture, multiple internal fixation and so on. Osteochondral injury after acute patellar dislocation in children and adolescents. Keyword Highlighting [6]. Please enable it to take advantage of the complete set of features! [2] This fracture type was 1st described by Busch in 1869. Choudhary RK, Tice JW. Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. Zeebregts CJ, Zimmerman KW, ten Duis HJ. [13] There are also many reports on OCF in non-weight-bearing area of LFC. Gao et al[70] reported a medial to medial-posterior distal femur approach in which the fragments were exposed through the interval space between the gracilis muscle and medial head of the gastrocnemius and the medial collateral ligament can be clearly exposed and protected. Anchor absorbable suture bridge fixation for this kind of OCF is not only effective, but also economical. -. Osteochondral fracture involving the weight-bearing portion of the lateral femoral condyle is relatively rare injury as it involves hyper flexion of the knee at the time of . [73] This approach is suitable for the treatment of Hoffa fracture with patella dislocation. This approach can also be used to treat comminuted fractures or complex Hoffa fractures.[18]. Furthermore, a Hoffa fracture is associated with cruciate ligament injury. In these cases, avulsion of the anterior cruciate ligament along with a large chunk of bone at its insertion[17] can lead to a Hoffa fracture. patellar margin thus corresponding to impaction injuries. [85]. 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. This method is also recommended for patients with osteoporosis, metaphyseal extension, or comminuted Hoffa fractures. A rare case of bicondylar. (C) The free edge of the anterior foot of the meniscus was rough (degree I). 2007;41 Suppl 2:105-12. Int Orthop. 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. At present, open reduction is often used to treat osteochondral fractures. Analysis of functional outcome of Hoffa fractures: a retrospective review of 32 patients. Braune C, Rehart S, Kerschbaumer F, Jger A. [50,51] An open supracondylar- intercondylar distal femoral fracture has a 2.8 times more chance of a Hoffa fracture than a closed distal femoral fracture. J Orthop Trauma 2002;16:17881. may email you for journal alerts and information, but is committed Injury 2011;42:14958. Federal government websites often end in .gov or .mil. Somford et al[65] showed that the repair strength of absorbable screw fixation is weak, knee joint activity produces greater shear stress, and there is a risk of screw breakage; thus, careful selection of the surgical plan is recommended. J Knee Surg. Based on plate position, screws can be combined with a lateral antigliding plate[84] or a posterior antigliding plate.[55,87]. Hoffa fractures are coronal-plane fractures of the femoral condyle, which are rarer than sagittal-plane condylar fractures. Li R, Guo G, Chen B, Zhu L, Lin A. Arthroscopicallyassisted reduction and fixation of an old osteochondral fracture of the lateral femoral condyle. Efficacy of multiple Acutrak hollow head compression screws in the, [68]. [19]. Smith EJ, Crichlow TP, Roberts PH. At present, open reduction is often used to treat osteochondral fractures. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures . [102]. 2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. [84]. (C) Making a small incision on the outside of the knee joint, it is convenient to drill two 2.0mm bone channels from the distal end of the femur from the outside to the intercondylar fossa. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging. Irreducible, incarcerated vertical dislocation of patella into a. The swashbuckler: a modified anterior approach for fractures of the distal femur. Surgical treatment of femoral medial condyle fracture with lag screws You may be trying to access this site from a secured browser on the server. Recently, impaction fractures in the non-weight-bearing area of the lateral femoral condyle were reported in 16 of 6600 patients who underwent knee MRI. One hundred five relevant articles were reviewed, and the clinical knowledge base was summarized. . (A) Use of anterior cruciate ligament locator to assist drilling at the distal end of the femur. Am J Sports Med. [27]. Some error has occurred while processing your request. After 1 year follow-up, good functional and radiographic outcome were obtained. [65]. According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis. Papadopoulos AX, Panagopoulos A, Karageorgos A, et al. Lateral femoral condyle osteochondral fracture combined to patellar Tan Y, Li H, Zheng Q, et al. [51]. eCollection 2021 Jan. Uimonen MM, Repo JP, Huttunen TT, Nurmi H, Mattila VM, Paloneva J. Knee Surg Sports Traumatol Arthrosc. In anterior cruciate ligament reconstruction, an anterior medial approach to the femoral tunnel allows restoration of the position of the tendon graft and increases rotation stability when an expanded bone tunnel is used for the graft. Jabalameli M, Bagherifard A, Hadi H, et al. We do not do patellar medial collateral ligament repair to reduce complications such as knee joint adhesion. 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. Radiographic features Usually, subchondral fractures present as linear or curvilinear structures often paralleling the subchondral bone plate, with or without areas of subchondral collapse 2. Chauhan A. Irreducible, incarcerated vertical dislocation of the patella into a. Nonunion of a, [62]. Soni A, Sen RK, Saini UC, et al. [9] The pain due to these combined injuries often exceeds that caused by the Hoffa fracture, which can lead physicians to miss the latter. 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.) 1994;2:1926. 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. Screw pullout strength: a biomechanical comparison of large-fragment and small-fragment fixation in the tibial plateau. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. White EA, Matcuk GR, Schein A, et al. [7]. Radiography can reveal fracture lines. Med Sci Monit, 2012, 18: CS117CS120. [2]. Following Letenneur classification of coronal fractures of the femoral condyle in the 1970s and the publication of the second version of the Manual of Internal Fixation, the Hoffa fracture has become more widely recognized by orthopedists. [5-9] For children and individuals with osteoporosis, low-energy trauma can also lead to a Hoffa fracture. Wolters Kluwer Health According to the internal fixation principle, the antiglide plate should be fixed in the posterior position. modify the keyword list to augment your search. Distal femur fractures most often occur either in older people whose bones . (A) A blurred fracture line can be seen at the fracture of the lateral condyle of the femur. 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). Intra-operative fractures in primary total knee arthroplasty - a Calmet J, Mellado JM, Garcia Forcada IL, et al. A high-energy injury resulting in a Hoffa fracture of the medial condyle is often associated with a tibia fracture,[18] a bicondylar Hoffa fracture,[44,45] a dislocation of the patella,[14] a knee dislocation,[46] intercondylar and supracondylar fractures,[9,47] and pelvic[48,49] and femoral shaft fractures. (A) The fresh 1.5cm1.5cm fracture surface of the lateral condyle of femur was found under arthroscopy. Radiographs of knee joint show loose body in joint. Kapoor et al[74] recommended a direct posterior approach and a lazy S-shaped incision to expose the fracture. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. 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. Technique for Treatment of Subchondral Compression Fracture of the For more information, please refer to our Privacy Policy. Pathology. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. Screw insertion direction differs among operative approaches. J Bone Joint Surg Br 1989;71:11820. Westmoreland GL, McLaurin TM, Hutton WC. Epub 2007 Mar 23. One hundred five articles on Hoffa fractures were reviewed, and the clinical knowledge base was summarized. Two cartilage masses can be seen during the operation.
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