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. 2014 Sep;48(5):525-8.
doi: 10.4103/0019-5413.139883.

Irreducible, incarcerated vertical dislocation of patella into a Hoffa fracture

Prasad C Soraganvi  1 , Bs Narayan Gowda  1 , Ramakanth Rajagopalakrishnan  1 , Ashok S Gavaskar  2
Affiliations

Irreducible, incarcerated vertical dislocation of patella into a Hoffa fracture

Prasad C Soraganvi et al. Indian J Orthop. 2014 Sep.

Abstract

Rotational dislocations of patella, which involve rotation of the patella around a horizontal or vertical axis are rare. These rotational dislocations of patella are difficult to reduce by close methods. These dislocations can have associated osteochondral and retinacular injury. We report a case of a 20-year-old male who presented with swelling and pain in the right knee following a motor cycle accident. Radiological evaluation using the computed tomography revealed a patellar dislocation with a concomitant Hoffa fracture. Patella was rotated around the vertical axis and was incarcerated into the Hoffa fracture. This is a very rare injury and first of its kind to be reported. The difficulties in diagnosis, mechanism of injury and management have been discussed. We feel closed reduction of such an injury is likely to fail and open reduction is recommended.

Keywords: Hoffa fracture; Patella dislocation; femoral fracture; ligament; medial patellofemoral ligament; patella dislocation; quadriceps muscle.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
(a and b) Anteroposterior and lateral radiographs of knee joint showing dislocated patella and Hoffa fracture of femur
Figure 2
Figure 2
(a and b) Computed tomography scan showing incarcerated vertically dislocated patella into Hoffa fracture
Figure 3
Figure 3
Intraoperative photograph showing incarcerated patella with articular surface facing outward
Figure 4
Figure 4
3 months followup radiograph of knee anteroposterior view showing union of Hoffa fracture
Figure 5
Figure 5
(a and b) 2 years followup clinical photograph of patient showing near normal range of knee flexion and extension without extensor lag
Figure 6
Figure 6
(a and b) 2 year followup anteroposterior and lateral radiograph after screw removal showing patella located at normal place and fracture united
See this image and copyright information in PMC

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