At present, open reduction is often used to treat osteochondral fractures. [16]. A patient, 15-year-old, female student. J Knee Surg 2008;21:23540. In this paper, three cases of osteochondral fracture of lateral femoral condyle were treated with arthroscopic TWINFIX Ti suture anchor internal fixation, and good results were obtained. For simple fractures of the medial condyle, a medial parapatellar surgical approach is most commonly used. J Orthop Surg Res 2012;7:21. [15]. Coronal fractures of the lateral femoral condyle. Surgically treated Hoffa Fractures with poor long-term functional results. We searched Medline, Embase, Cochrane Library, Google Scholar, China National Knowledge Infrastructure, and China Biology Medicine disc, using the terms Hoffa fracture and coronal fracture of femoral condyle.. Lateral-view radiograph of the left knee demonstrating an abnormally deep depression of the medial condylopatellar sulcus (arrow). A rare case of unicondylar medial, [24]. Vaishya R, Singh AP, Dar IT, et al. Intra-articular dislocation of the patella with associated, [26]. [Patella infera. eCollection 2020 Jun. Arthroscopic management of a posterior femoral condyle (Hoffa) fracture: surgical technique. Pathology. Nonunion of a, [62]. This approach fully exposes the fracture and does not risk damaging the nerves and blood vessels,[67] making the operation simple and safe. Min L, Tu CQ, Wang GL, et al. We prospectively documented all potential cases of non-weight-bearing posterior subchondral impaction fractures of the femoral condyles diagnosed on magnetic resonance imaging (MRI) of the knee performed at our institution between January 2006 and December 2011. [7] The development of trochlear sulcus of femur was classified as type A according to Dejour et al,[8] and the TT-TG[9] was 15mm. 2013;33:5118. Zeebregts CJ, Zimmerman KW, ten Duis HJ. Complications of humerus fracture treatment. According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis. A lateral incision plus Gerdy tubercle osteotomy provides full exposure[68] especially in cases of coronal fracture of the lateral condyle. Recently, impaction fractures in the non-weight-bearing area of the lateral femoral condyle were reported in 16 of 6600 patients who underwent knee MRI. Surgical versus nonsurgical treatments of acute primary patellar dislocation with special emphasis on the MPFL injury patterns. [53] In addition, partial nondisplaced Hoffa fractures are difficult to diagnose on anteroposterior and lateral views of the knee because the fracture lines often overlaps the side or lateral condyle, which can result in a missed diagnosis in as many as 30% of cases.[9,18]. [15,16] These forces cause gross displacement of the condyle, which can not only rupture the quadriceps tendon but also perforate the skin, resulting in an open injury. Lee SY, Niikura T, Iwakura T, et al. [31]. Liebergall M, Wilber JH, Mosheiff R, et al. modify the keyword list to augment your search. Making the diagnosis of a Hoffa fracture is challenging. Our hospital's institutional review board waived the need for ethical approval for this review paper. For bicondylar fractures, a median parapatellar incision can be used. ASER Core Curriculum Illustration Project: coronal femoral condyle (Hoffa) fracture. Neglected. Fixation with headless screws can reduce the degree of cartilage injury. This method is beneficial for reducing small and rotating fragments. Irreducible, incarcerated vertical dislocation of patella into a. [9]. In the type II (bicondylar Hoffa fracture), both condyles are fixed with anteroposterior screws. [59] For children and individuals with osteoporosis, low-energy trauma can also lead to a Hoffa fracture. [91]. [83]. In the AO classification, Hoffa fracture is classified as type B3.2. [77]. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. [100]. Knee flexion was limited less than 60 within 8 weeks after operation, partial weight-bearing was allowed at 8 weeks, followed by full weight bearing from 12 weeks after operation. A comparison of the clinical effect of two fixation methods on Hoffa fractures. Shah JN, Howard JS, Flanigan DC, et al. J Orthop Trauma 2006;20:2736. As the knee is being extended and in full extension, it can be seen that femoral and tibial surfaces do not articulate with each other. Zhou, Yabin MDa,b; Pan, Ying MDc; Wang, Qingxian MDa; Hou, Zhiyong MDa; Chen, Wei MDa,, aDepartment of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Orthopedic Research Institution of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, bDepartment of Orthopedic Surgery, Shijiazhuang The Third Hospital. Springerplus 2016;5:1164. According to the severity of Hoffa fracture and combined injuries, a reasonable treatment plan can be developed. Among the various types of Hoffa fractures, the Letenneur II is unique because the fragments are small and difficult to fix, and poor blood supply to the fragments impairs its healing. The weight-bearing joints such as the knee, hip, and ankle joints are more commonly affected. [39,40] Wagih[41] reported that, under general anesthesia, patients with Hoffa fracture have instability at 30 of flexion but not with leg straightened. The Authors. (LTC, Lateral Tibial Condyle.) According to the internal fixation principle, the antiglide plate should be fixed in the posterior position. [95] Because Hoffa fractures are intra-articular, the success of anatomical reduction and firm internal fixation is closely related to postoperative complications like traumatic arthritis. For example, a fracture line dividing the femoral condyle surface into 2 parts is classified as type I; 2 fracture lines dividing the femoral condyle surface into 3 parts is type II; and 3 or more fracture lines dividing the femoral condyle surface into 4 or more parts is type III. Frangakis EK. following anterior cruciate ligament repair) Location The recognized sites of osteochondral defects are: femoral condyle (most common in the lateral aspect of the medial femoral condyle) humeral head talus capitellum of the humerus Staging [58]. Injury, 2005, 36: 862865. Recurrence after patellar dislocation. to maintaining your privacy and will not share your personal information without Your message has been successfully sent to your colleague. FOIA Li ZX, Song HH, Wang Q, et al. However, in recent years, some authors[35] reported OCF involving the weight-bearing area of LFC. The functional and radiographic outcome were satisfactory at 18 months after operation. An attempt to treat Hoffa fractures under arthroscopy: A case report. (B) BULLET fixed at the entrance of the lateral bone canal of the distal femur. Fractures of the thighbone that occur just above the knee joint are called distal femur fractures. This method is also recommended for patients with osteoporosis, metaphyseal extension, or comminuted Hoffa fractures. Rofo. (C) The free edge of the anterior foot of the meniscus was rough (degree I). Med Sci Monit, 2012, 18: CS117CS120. Meyer C, Enns P, Alt V, et al. [54] However, popliteal and gastrocnemius muscle traction and foot or ankle movement can lead to fracture redisplacement,[5557] which can cause delayed fracture healing, nonunion, traumatic arthritis, knee dysfunction, and other complications. The most common way to fracture the femoral condyles is jumping from a large height. Mashoof AA, Scholl MD, Lahav A, et al. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. J Bone Joint Surg Am 2005;87:5649. [50,51] An open supracondylar- intercondylar distal femoral fracture has a 2.8 times more chance of a Hoffa fracture than a closed distal femoral fracture. The patient's treatment plan included 6 weeks of weight bearing as tolerated for the left lower extremity while wearing a knee brace that prevented the final 20 of knee extension, and a program of range-of-motion and progressive resistive exercises, with eventual emphasis on sport-specific activities. Incarcerated patellar tendon in. [15,1720] The fracture line its inclination angle of a Hoffa fracture depend on the degree of knee joint flexion at the time of trauma[18]; as the angle of knee flexion increases, the fracture line will occur farther from the posterior cortex of the femoral-condyle. Lewis SL, Pozo JL, Muirhead-Allwood WF. In these fractures, the popliteus tendon and the lateral head of the gastrocnemius muscle remain attached to the fragment. Open bicondylar, [23]. However, Gavaskar et al[2] argued that no evidence confirms this correlation. [102] Therefore, open reduction and internal fixation is recommended to minimize cartilage damage and allow appropriate treatment of the bone and soft tissues. Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence. The term comminuted fracture refers to a bone that is broken in at least two places. Sagittal, fat-suppressed, proton density-weighted magnetic resonance image of the left knee demonstrating a focal indentation of the anterior portion of the medial femoral condyle (orange arrow . J Bone Joint Surg Am 2006;88:22704. [99]. [11] The presence of a thick ligament in a relatively small femur is also a risk factor for a Hoffa fracture.[2730]. Fracture and dislocation compendium: Orthopaedic Trauma Association Committee for Coding and, [35]. Transverse Hoffas or deep. [56]. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. Paa L, Vesel R, Koi J, et al. Wang JY, Liu Y, Li Y, et al. The association between supracondylar-intercondylar distal femoral fractures and coronal plane fractures. Am J Sports Med. your express consent. Chin J Orthop Trauma 2009;9:8503. Bali K, Mootha AK, Krishnan V, et al. The incidence ratio in male and female patients is in the range . The natural history. Depression Of more than 5 mm in a type 3 fracture can treated by elevation from below and (d' supported by bone grafts and fixation. In these cases, avulsion of the anterior cruciate ligament along with a large chunk of bone at its insertion[17] can lead to a Hoffa fracture. [90]. Hoffa fracture with cruciate ligament, lateral collateral ligament, or meniscus injuries can be treated with arthroscopic surgery,[90] which has the advantages of minimal invasion, less of an effect on blood supply, early postoperative return to functional exercise, and effective prevention of nonunion and joint stiffness. Hawkins RJ, Bell RH, Anisette G. Acute patellar dislocations. After the incision was closed in layers, the lower limb was splinted for 6 weeks, isometric exercises for the quadriceps began the day after surgery. [14,15] Diederichs et al[16] suggest that a first patellar dislocation is often treated conservatively, and loose body removal, microfracture and internal fixation should be selected according to the size and location of osteochondral block. Three types of fracture are defined based on the coronal fracture line (Fig. [55] Onay et al[79] performed a long-term follow-up study of Hoffa fracture patients treated with screws and observed that the screws provided sufficient biomechanical stability until the fractures were healed. Impact fractures can be classified either as ductile or brittle depending on the elongation pattern that is present. Seeley MA, Knesek M, Vanderhave KL. The CT classification[32] uses the anatomic femoral axis and a line parallel to the posterior cortex of the femoral condyle to divide the femoral condyle into a, b, and c regions. Search for Similar Articles Chauhan A. Irreducible, incarcerated vertical dislocation of the patella into a. Hoffa fractures are caused by shear stress between the femoral condyle and tibial plateau. An impact fracture is a form of failure where a metal separates into fragments due to a stress applied at a temperature below the metal's melting point. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. The swashbuckler: a modified anterior approach for fractures of the distal femur. [18]. Hoffa's fractures. 2021. An official website of the United States government. Received: 27 October 2022 / Received in final form: 8 November 2022 / Accepted: 9 November 2022. [42] Compared with anteroposterior and lateral films, oblique radiographic views can show minimally displaced fractures better[14] and can, therefore, be used as a routine examination method for a Hoffa fracture. Internal fixation with lag screws plus an antigliding plate for the, [88]. Viskontas DG, Nork SE, Barei DP, et al. impacted and stress fractures. For local soft-tissue injuries, external fixation can be used, but this may delay the time to mobility restoration and affect therapeutic efficacy. [9] The pain due to these combined injuries often exceeds that caused by the Hoffa fracture, which can lead physicians to miss the latter. [65]. See this image and copyright information in PMC. 2003;19:71721. [5] Viskontas et al[69] reported an extensile medial subvastus approach that allows better exposure of the surgical field and protects the blood supply of the bones comparing with the medial parapatellar approach. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. Primary traumatic patellar dislocation. Monocondylar fractures of the femur: a review of 13 patients. Before [9]. deep lateral sulcus sign - depression of lateral femoral condyle representing impaction fracture anterior tibial translocation sign Segond fracture arcuate fracture joint effusion CT Considered to have high specificity and sensitivity in detecting anterior cruciate ligament disruption 6. [1,2] However, most LFC cartilage injuries are located in the anterior non-weight-bearing area. [101]. Oral application of Qiangguyin Keli and alendronate sodium vitamin D3 tablets in postoperative anti-osteoporosis. The appropriate surgical plan is chosen based on the location of the Hoffa fracture, characteristics of the fracture line, fracture severity, and associated injuries. Further improvements in arthroscopic-assisted reduction and other minimally invasive surgery technologies will help improve patient prognosis. Miyamoto R, Fornari E, Tejwani NC. An appropriate surgical approach allowing full fracture exposure is selected based on fracture type. Nakagawa S, Arai Y, Inoue H, et al. Please enable scripts and reload this page. Knee Surg Sports Traumatol Arthrosc. Choudhary RK, Tice JW. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. Kini SG, Sharma M, Raman R. A rare case of open bicondylar, [67]. PMC Authors Keyword Highlighting your express consent. Intra-articular dislocation of the patella. Reconstruction of the anterior cruciate ligament of the knee joint can lead to iatrogenic Hoffa fracture. A high-energy injury resulting in a Hoffa fracture of the medial condyle is often associated with a tibia fracture,[18] a bicondylar Hoffa fracture,[44,45] a dislocation of the patella,[14] a knee dislocation,[46] intercondylar and supracondylar fractures,[9,47] and pelvic[48,49] and femoral shaft fractures. Jain A, Agrawal P, Chadha M, et al. Some error has occurred while processing your request. Complications of anterior cruciate ligament reconstruction with bone-patellar tendon-bone constructs: care and prevention. Orthop J Sports Med. [8]. [98]. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. J Pediatr Orthop B, 2013, 22: 344349. Osteochondral fractures of the lateral. Commonly used classifications include the Letenneur classification, a computed tomography (CT) classification, the AO classification, and modified AO classification. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . This kind of disease is commonly seen in the knee joint sprain during strenuous activity. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. Letenneur J, Labour PE, Rogez JM, et al. One hundred five relevant articles were reviewed, and the clinical knowledge base was summarized. Bone Joint J 2013;95-B:116571. Posterior wall blowout in anterior cruciate ligament reconstruction: avoidance, recognition, and salvage. Soft tissues are retracted to . Knee Surg Sports Traumatol Arthrosc. Based on plate position, screws can be combined with a lateral antigliding plate[84] or a posterior antigliding plate.[55,87]. Injury 2018;49:398403. [7]. In contrast, type II fractures have a high risk of nonhealing or delayed healing because of poor adhesion and poor blood supply. Anchor absorbable suture bridge fixation for this kind of OCF is not only effective, but also economical. Gao et al[70] reported a medial to medial-posterior distal femur approach in which the fragments were exposed through the interval space between the gracilis muscle and medial head of the gastrocnemius and the medial collateral ligament can be clearly exposed and protected. 1982;68:31725. 1996 ). modify the keyword list to augment your search. [5]. At present, open reduction is often used to treat osteochondral fractures. In reviewing left knee radiographs that had previously been interpreted as normal, the physical therapist noted an abnormally deep depression of the medial condylopatellar sulcus, which was concerning for a possible impacted osteochondral fracture. In addition to changes in bone mineral composition and a reduced proportion of bone matrix in patients with osteoporosis, changes in bone microstructure, thinning of bone cortex, and reduction in the number and size of bone trabeculae result in a decreased bone load capacity[26] and an increased risk of a Hoffa fracture with low-energy trauma. (B) 1.5cm1.5cm free bone was found in the knee joint cavity, and the bone fracture was intact. Low-energy trauma can cause Hoffa fractures in people with skeletal immaturity[24] as well as in those with low bone mass, such as patients with osteoporosis. When high-energy trauma involves the distal femur, the lateral condyle is often damaged[18] before the medial condyle because of the physiologic genu valgum of the knee joint. [33] Dua and Shamshery[34] proposed a classification method that supplements the AO classification with proper surgical planning to optimize outcomes. [78] Previous studies showed the use of many screws to fix the Hoffa fracture, such as cancellous, cannulated, and headless used in a lag technique. MRI of osteochondral defects of the lateral, [3]. Arthroscopy. [11,12] The bone marrow edema at the posterolateral aspect of the LFC suggest that the knee joint is highly flexed during patellar dislocation. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. [72]. Malays Orthop J 2017;11:204. [84]. Partial weight bearing with crutches is started at 6 to 8 postoperative weeks. Unable to load your collection due to an error, Unable to load your delegates due to an error. [64] Open reduction and internal fixation is the 1st choice for the treatment of displaced Hoffa fractures, and it is also suitable for the treatment of nondisplaced Hoffa fractures. Sanders TG, Paruchuri NB, Zlatkin MB. One hundred five articles on Hoffa fractures were reviewed, and the clinical knowledge base was summarized. Lateral Femoral Condyle (LFC) osteochondral fracture (HSL, Hill-Sachs-like Lesion) can be seen in 30 of knee flexion. Type III is an oblique fracture of the femoral condyle with the fracture line located anterior to the joint capsule, anterior cruciate ligament, lateral collateral ligament, popliteal tendon, and the lateral head of the gastrocnemius muscle. The distal femur is where the bone flares out like an upside-down funnel. J Clin Orthop Trauma 2014;5:3841. Type II is a fracture horizontal to the base of the posterior condyle with fracture lines located posterior to the attachment point of the lateral collateral ligament. Callewier et al[23] reported a patient who used absorbable pin fixation to treat OCF in the weight-bearing area of LFC. [2,77] The heads of screws placed through the articular cartilage are countersunk to prevent damage to the cartilage. Supervision: Qingxian Wang, Zhiyong Hou, Wei Chen. (A) Through the hollow needle channel of the femoral intercondylar fossa, the folding corner of the PDS line are exposed to the knee joint cavity through the bone canal. In addition, the lateral antiglide plate can provide stable support, and in combination with autologous bone grafting can promote fracture healing,[38,55,89] which is especially useful for treating old Hoffa fractures. [43] If radiographic examination is not diagnostic but a Hoffa fracture is suspected, a CT scan, which is the gold standard for diagnosis of a Hoffa fracture, should be performed. 1986;14:11720. How to cite this article: Wu L, Liu C, Jiang B, He L. Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report. High-energy trauma is a common cause of a Hoffa fracture, although low-energy trauma and iatrogenic injury can also lead to these fractures. Cheng S, Zaidi SF, Linnau KF. Singh AP, Dhammi IK, Vaishya R, et al. Gelber PE, Erquicia J, Abat F, et al. Medicine (Baltimore). 2022 Dec 16;101(50):e32104. AIMER was located at the outlet of the medial bone canal of the lateral condyle of the femur, and the HANDLE was adjusted to a suitable angle (5060). An unusual fracture of the lateral femoral condyle in a child. [17]. The site is secure. [14]. [96]. We report a case of patellar dislocation with OCF in the weight-bearing area of LFC. Kapoor C, Merh A, Shah M, et al. [28]. Smith EJ, Crichlow TP, Roberts PH. A meta-analysis by Khle et al[6] show that there is no unified treatment for osteochondral fractures (OCF) of knee joint at present, and the overall failure rate is 17%. Hawkins et al[18] found that the recurrent dislocation rate of patients with primary patellar dislocation is related to congenital femoral trochlear dysplasia, high patellar position and large TT-TG. lateral femoral condyle fractures in 80% Angiography indications ankle-brachial index (ABI) <0.9 obvious signs of vascular injury i.e., hard and soft signs (pulselessness, rapidly expanding hematoma, massive bleeding, etc.) Acta Orthop Belg 2001;67:1328. [57]. The Letenneur classification, computed tomography (CT) classification, the AO classification, and the AO classification with supplement are widely used in clinics to categorize Hoffa fractures. Heuschen UA, Gohring U, Meeder PJ. [21]. Intertrochanteric femoral fractures account for 3.13% of total adult fractures, 24.56% of femoral fractures, and 50% of proximal femoral fractures (Koval et al. Intra-articular dislocation of the patella with incomplete rotation--two case reports and a review of the literature. 8600 Rockville Pike Arthroscopy 1996;12:2247. Wagih AM. Injury 2011;42:14958. 1 It has been proved that compression of the posterior border of . When the patient has patellar dislocation with OCF in the weight-bearing area of LFC, surgical treatment and internal fixation is the treatment of choice if the OCF can be fixed. Dhillon MS, Mootha AK, Bali K, et al. This rare lesion is diagnostically challenging and requires an adapted and prompt treatment. Soraganvi PC, Narayan Gowda B, Rajagopalakrishnan R, et al. Radiographs of knee joint show loose body in joint. Epub 2018 Oct 4. J Knee Surg 2013;26(Suppl 1):S8993. Fractures of the distal femur typically occur in the axial and sagittal planes. . Shetty GM, Wang JH, Kim SK, et al. [4]. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. [7,10] The finding of medial or lateral stress test and anterior and posterior drawer test were reported to be positive in some patients. Nanda R, Yadav RS, Thakur M. Intra-articular dislocation of the patella. Comminuted fractures are caused by severe traumas like car accidents. Surgical, [71]. A 15-year-old female student accidentally sprained her right knee while participating in sports activities. Friederichs MG, Greis PE, Burks RT. [29]. Radiographic features Usually, subchondral fractures present as linear or curvilinear structures often paralleling the subchondral bone plate, with or without areas of subchondral collapse 2. Partial ceramic crowns: influence of ceramic thickness, preparation design and luting material on fracture resistance and marginal integrity in vitro. Pathology The likely mechanism is a hyperextension or impaction injury with a collision of the femoral condyle and the posterior tibial plateau during the rotational movement responsible for injuring the ACL, most commonly the pivot-shift. Please try after some time. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. [20]. -, Enea D, Busilacchi A, Cecconi S, Gigante A. Latediagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report. [19] Therefore, lateral condyle fracture is significantly more common than medial condyle fracture. [102]. 2014;22:238895. Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. The authors have no conflicts of interest to disclose. After 1 year follow-up, good functional and radiographic outcome were obtained. [12,13] Most researchers[2,7,14] currently believe that when the knee is in 90 of flexion and emergency braking is performed while driving a car, an axial force in either a varus or valgus direction is transferred from the proximal femur to the femoral condyle. [3,4] In 1888, Hoffa described coronal fracture of the femoral condyle but did not indicate the source of the previous reference. Would you like email updates of new search results? and transmitted securely. A rare case of bicondylar. Search for Similar Articles Calmet J, Mellado JM, Garcia Forcada IL, et al. J Trauma 2000;48:15960. Arthroscopy 2012;28:13817. Data is temporarily unavailable. Nondisplaced fractures can be managed conservatively; however, they involve a high risk of redisplacement. For more information, please refer to our Privacy Policy. Tong W, Yang J, Xu PL, et al. Nonunion of coronal shear fracture of femoral condyle. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging. Analysis of functional outcome of Hoffa fractures: a retrospective review of 32 patients. Research Article: Systematic Review and Meta-Analysis. After hospitalization, the patients underwent computed tomography scan and magnetic resonance examination. (A) MRI examination of the right knee joint: the bone continuity at the edge of the lateral condyle of the right femur was poor, the patchy high signal intensity was seen in the bone marrow cavity of the lateral condyle of the femur, and the local cartilage became thinner in the corresponding area. Arthrosc Tech 2015;4:e299303. Unauthorized use of these marks is strictly prohibited. This is the first report on a fracture of medial femoral condyle treated with this implant. [66]. may email you for journal alerts and information, but is committed Some error has occurred while processing your request. [6]. absorbable internal fixation; dislocation of patella; femoral condyle; osteochondral fracture. Osteochondral injuries of the knee in pediatric patients. Shah et al[19] systematically reviewed the recurrent patellar dislocation and found that the complication rate of patellar medial collateral ligament reconstruction was as high as 26.1%. patellar margin thus corresponding to impaction injuries. [34] The clinical diagnosis of a Hoffa fracture relies on trauma history, physical examination, imaging, and other objective indicators as well as increased suspicion based on the history and positive signs.[35,36]. Hingelbaum S, Best R, Huth J, et al. Long term results of unicondylar fractures of the femur. [39]. Operative. You may search for similar articles that contain these same keywords or you may findings identifies vascular segments with diminished flow vascular injury [47]. The https:// ensures that you are connecting to the [38]. (D) Under knee arthroscopy, obvious fracture line of lateral condyle of bone and osteochondral fracture of the lateral femoral condyle can be seen. Am J Sports Med 2008;36:37994. [33]. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study aimed to systematically review the clinical knowledge base of Hoffa fractures to facilitate the diagnosis and management of such injuries. Transverse Hoffa's or deep osteochondral fracture? Treatment options include loose body removal, microfracture, multiple internal fixation and so on. Plate fixation for Letenneur type I. Reconstruction of Large Osteochondral Lesions in the Knee: Focus on Fixation Techniques. [10]. Radiography can reveal fracture lines. [19]. [53,91] However, some Hoffa fractures combined with a tear of the posterolateral horn of the lateral meniscus are identified intraoperatively, and tear of the lateral meniscus can be repaired with suture anchors.
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