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. 2013 May;47(3):302-6.
doi: 10.4103/0019-5413.111509.

Conjoint bicondylar Hoffa fracture in an adult

Rehan Ul Haq  1 , Prashant Modi, Ik Dhammi, Anil K Jain, Puneet Mishra
Affiliations

Conjoint bicondylar Hoffa fracture in an adult

Rehan Ul Haq et al. Indian J Orthop. 2013 May.

Abstract

Conjoint bicondylar Hoffa fracture is an extremely rare injury. Only one case has been reported previously in the pediatric age group. We describe this injury in a 17-year-old male who presented following a fall with direct impact on his semiflexed right knee. Plain radiographs were inadequate to define the exact pattern of injury. Computed tomographic (CT) scans demonstrated the coronal fracture involving both the femoral condyles which were joined by a bridge of intact bone. The patient was treated with open reduction and internal fixation using swashbuckler (modified anterior) approach. Union occurred within 3 months and at final followup (at 18 months) the patient had a good clinical outcome. The possible mechanism of injury is discussed.

Keywords: Bicondylar Hoffa fracture; classification; conjoint; swashbuckler approach.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Clinical photograph showing a 1cm × 1cm lacerated wound over the anterior aspect of the knee at the point of direct impact
Figure 2
Figure 2
Plain anteroposterior and lateral radiographs were inadequate to define the exact fracture pattern
Figure 3
Figure 3
Axial CT scan cuts showing a bicondylar Hoffa fracture joined by a bridge of intact bone
Figure 4
Figure 4
Intraoperative photographs showing the swashbuckler approach (a), pattern of fracture (b), provision reduction (c) and fixation with cannulated cancellous screws (d)
Figure 5
Figure 5
Clinical photographs at 18 months showing range of motion
Figure 6
Figure 6
Followup radiographs anteroposterior (a) and lateral (b) views at 18 months showing radiological union, without any avascular necrosis, osteoarthritis or implant breakage
Figure 7
Figure 7
A line diagram showing conjoint bicondylar Hoffa fracture following a posterior and upward directed force (F) in a semiflexed knee
Figure 8
Figure 8
A line diagram showing nonconjoint bicondylar Hoffa fracture following a posterior and upward directed force (F) in a hyperflexed knee
Figure 9
Figure 9
Classification of distal femoral fractures
See this image and copyright information in PMC

References

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