Compression screws and buttress plate versus compression screws only for Hoffa fracture in Chinese patients: a comparative study

Abstract

Objective: To compare compression screws and buttress plate (CS plus BP) with compression screws only (CS) in treating patients with Hoffa fracture.

Methods: This retrospective study included Chinese patients with Hoffa fracture treated by open reduction and internal fixation. Radiographs and clinical outcomes (range of movement [ROM], bone union and Knee Society Score [KSS]) were compared between patients treated using CS plus BP versus CS only.

Results: At 4 months following surgery, significantly better outcomes were shown in the CS plus BP group ( n = 24) versus CS only group ( n = 21) regarding ROM (120.4 ± 5.2° versus 110 ± 7.1°) and KSS (85.5 ± 4.1 versus 79.7 ± 3.3). At the 12-month follow-up, significantly better outcomes were maintained in the CS plus BP versus CS only group regarding ROM (126.2 ± 7.4° versus 120.5 ± 8.2°) and KSS (88.3 ± 4.6 versus 84.2 ± 4.0). At the final follow-up, all patients had normal fracture healing and no malunion, nonunion or reduction loss.

Conclusions: Fixation with CS plus BP for Hoffa fracture is effective and reliable, and may provide more adequate stability and better outcomes versus CS only.

Keywords: Hoffa fracture; buttress plate; comparative study; compression screw.

Figure 1.

Representative case from the current study of a 48-year-old male patient with a type II Hoffa fracture acquired following a fall: (a) anteroposterior and (b) lateral knee radiographs showed a Hoffa fracture which was not detected by healthcare professionals; (c and d) computed tomography reconstructions clearly demonstrating the fracture; (e) anteroposterior and (f) lateral radiographs at four months following surgery, showing that the fracture had adequate stability and no displacement; (g and h) representative images at 12 months following surgery, showing the patient with a stable and functional knee.

Figure 2.

Representative case from the current study of a 42-year-old male patient with type III Hoffa fracture acquired during a motor vehicle accident: (a) anteroposterior and (b) lateral knee radiographs, and (c and d) computed tomography reconstructions showing the Hoffa fracture; (e and f) radiographs showing a buttress plate and two cannulated lag screws placed during surgical treatment; and (g and h) representative images at the final 12-month follow-up, at which the patient had completely recovered knee function.