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. 2022 Apr 4;14(4):e23829.
doi: 10.7759/cureus.23829. eCollection 2022 Apr.

The Functional and Radiological Outcome of Hoffa's Fracture Treated With Cannulated Cancellous Screws

Ajay Kurahatti  1 , Hariprasad Seenappa  1 , Arun H Shanthappa  1 , Nagakumar J S  1
Affiliations

The Functional and Radiological Outcome of Hoffa's Fracture Treated With Cannulated Cancellous Screws

Ajay Kurahatti et al. Cureus. .

Abstract

Introduction: Distal femur AO type 33 B fractures consist of partial articular fractures subdivided into three types namely sagittal lateral condyle fracture, medial condyle fracture, and coronal split fracture. Coronal plane fractures of the distal femur are less frequent compared to sagittal plane fractures and are known as Hoffa fractures. The mechanism of injury is usually a direct anteroposterior force to the flexed and abducted knee for lateral condylar fractures and a direct impact on the medial side of the knee in flexion for a medial condylar fracture. Various approaches like lateral parapatellar for lateral condylar Hoffa's fixation, with or without posterior approach for open reduction of Hoffa's fracture with screw or buttress plate fixation, medial parapatellar approach for medial condylar Hoffa's fracture screw fixation are used.

Materials and methods: This study was conducted at R L Jalappa Hospital and Research Center attached to Sri Devaraj Urs Medical College, Kolar, India, from June 2017 to May 2020 with 17 patients as a sample size.

Results: Seventeen patients with Hoffa's fracture were treated with cannulated cancellous screws with lag effect including 12 males and five females with a mean age of 31.1 years. The range of motion ranged from 120 to 135 degrees of flexion with a mean of 125.2 degrees. Three patients had extensor lag ranging from 5 to 10 degrees with an average of 6.3 degrees. Neer scores were excellent in 11, good in four, and fair in two patients. The average fracture union time for the lateral condyle was 16.4 months and for the medial condyle, it was 16.7 months.

Conclusion: Restoration of articular anatomy and its congruence is of paramount importance for better surgical outcomes. Closed or open reduction and stable fixation with anteroposterior cannulated cancellous screws are essential. A good post-operative rehabilitation program is required for better outcomes.

Keywords: articular anatomy; cannulated cancellous screw; hoffa's fracture; lag screw; neers score.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Anteroposterior and lateral radiograph of medial condyle Hoffa's fracture before surgery
Figure 2
Figure 2. Anteroposterior and lateral radiograph of medial condyle Hoffa's fracture after fixation.
Figure 3
Figure 3. Post-operative follow-up of the patient with range of motion of knee at six weeks
Figure 4
Figure 4. Post-operative follow-up of a patient with range of motion of knee at six months
Figure 5
Figure 5. Post-operative follow-up of a patient with range of motion of knee at one year
See this image and copyright information in PMC

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