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Case Reports
. 2017 Nov 23;1(8):e060.
doi: 10.5435/JAAOSGlobal-D-17-00060. eCollection 2017 Nov.

Overlooked Hoffa Fracture in a Patient With Neurofibromatosis-1

Martin Missmann  1 , Karl Peter Benedetto  1
Affiliations
Case Reports

Overlooked Hoffa Fracture in a Patient With Neurofibromatosis-1

Martin Missmann et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Hoffa fractures are rare fractures of either one or both femoral condyles in the coronal plane. They usually occur as a result of high-velocity, high-energy trauma with axial compression of the lower limb and a typically flexed position of the knee. The lateral condyle is affected more frequently. Diagnosis of a coronal fracture is often missed in conventional radiography, so additional CTs of the knee are highly recommended in unclear cases. Because of permanent shearing forces, fracture healing is unlikely without surgical treatment. In the case we present here, the Hoffa fracture occurred after minimal trauma and was associated with an ipsilateral patellar dislocation and a meniscal tear. The fracture was initially overlooked. Bone quality was affected by a preexisting neurofibromatosis-1 condition.

Keywords: Femoral fracture; High-velocity trauma; Hoffa fracture; Neurofibromatosis-1; Osteopenia; Skeletal deformities.

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Conflict of interest statement

Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this chapter: Dr. Missmann and Dr. Benedetto. The patient provided written consent for publication.

Figures

Figure 1
Figure 1
The patient with clinical signs of neurofibromatosis-1: short stature, thoracolumbar kyphosis, and scoliosis. He underwent spinal surgery twice because of reduced bone quality. Multiple café-au-lait macules and fibromas are visible.
Figure 2
Figure 2
A, Axial radiograph of the left patella. B, Lateral radiograph of the left knee. C, AP radiograph of the knee.
Figure 3
Figure 3
A and B, Three-dimensional rendering of the Hoffa fracture before and after surgical treatment.
See this image and copyright information in PMC

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