impaction fracture lateral femoral condyle treatment

The most common way to fracture the femoral condyles is jumping from a large height. Lee SY, Niikura T, Iwakura T, et al. Intra-articular corrective osteotomy for malunited. Arthroscopy-assisted fracture fixation. 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. government site. Careers. 2018 Oct;21(5):308-310. doi: 10.1016/j.cjtee.2018.08.004. Please try again soon. Comminuted fractures are caused by severe traumas like car accidents. eCollection 2021 Jan. Uimonen MM, Repo JP, Huttunen TT, Nurmi H, Mattila VM, Paloneva J. Knee Surg Sports Traumatol Arthrosc. [21]. Springerplus 2016;5:1164. After 6 months, the patient could resume normal sporting activities, and the knee joint extension and flexion were normal without knee instability and pain. [20]. Injury 2011;42:14958. [76,77] Fixation with 2 or more screws can prevent rotation and rotational displacement. Federal government websites often end in .gov or .mil. Osteochondral fractures of the lateral. Arthrosc Tech 2015;4:e299303. Lee et al[13] reported that Gerdy osteotomy combined with an anterior lateral parapatellar approach provides appropriate exposure for bicondylar Hoffa fractures. Viskontas DG, Nork SE, Barei DP, et al. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. This method is beneficial for reducing small and rotating fragments. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. J Clin Orthop Trauma 2015;6:4650. Intra-articular dislocation of the patella with incomplete rotation--two case reports and a review of the literature. J Bone Joint Surg Am 2008;90:46370. 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. 2022 Dec 16;101(50):e32104. [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. Bone Joint J 2013;95-B:116571. [9]. Rosenberg NJ. Knee flexion angle is more important than guidewire type in preventing posterior femoral cortex blowout: a cadaveric study. Apropos of 128 cases]. Conjoint bicondylar, [45]. [75]. doi: 10.1016/j.eats.2020.02.016. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. For Letenneur II and some Letenneur III fractures close to the posterior cortex of the femoral condyle, cannulated lag screw fixation is commonly used. Pa a et al[17] reported that 10 patients with patellar osteochondral mass less than 2.7mm2 caused by patellar dislocation still achieved good function only by taking out the loose body, and no patellar dislocation was found. For tibial fractures, the use of bone plates or intramedullary nails is recommended if the condition of the local soft tissue is suitable. In types III and IV (unicondylar coronal plane fracture with supracondylar or intercondylar distal femoral fractures, respectively), fixation is needed as for isolated Hoffa fracture in addition to stabilization with a metaphyseal bridging implant or a fixed-angle device. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. Comminuted fractures are a type of broken bone. The plate fit the bone surface well, despite some bending, the clinical and radiological outcomes were good. 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. The bone mass is missing at the fracture. Busam ML, Provencher MT, Bach BR. [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. When patients have tenderness along the medial edge of patella and knee joint effusion, it is necessary to actively improve MRI examination, to rule out osteochondral injury. [10] Some of these patients may have a history of poliomyelitis that predisposes individuals to osteoporosis. 2021 Jan 26;9(1):2325967120974649. doi: 10.1177/2325967120974649. Westmoreland GL, McLaurin TM, Hutton WC. Acta Orthop Traumatol Turc. Acta Orthop Traumatol Turc 2014;48:3837. Cartilage. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. Xray examination of right knee joint: free bone mass can be seen at, (A) MRI examination of the right knee joint: the bone continuity at the, (A) The fresh 1.5 cm 1.5 cm fracture surface of the lateral, (A) One 1.5 mm Kirschner wire temporarily fixed the fracture block of the, (A) Use of anterior cruciate ligament locator to assist drilling at the distal, (A) Through the hollow needle channel of the femoral intercondylar fossa, the folding, Surgical diagrams (A: osteochondral fracture, Surgical diagrams (A: osteochondral fracture of the lateral femoral condyle; B: fixation of, CT examination 6 months after operation: one screw internal fixation, regular external condyle, (A) A blurred fracture line can be seen at the fracture of the, MeSH This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. [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]. 2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. Int Orthop. Irreducible, incarcerated vertical dislocation of patella into a. Long term results of unicondylar fractures of the femur. Highlight selected keywords in the article text. . [ 21] Matthewson et al [ 21] reported for the first time that patellar dislocation complicated with OCF of LFC was treated with early Osteochondral injury after acute patellar dislocation in children and adolescents. Partial ceramic crowns: influence of ceramic thickness, preparation design and luting material on fracture resistance and marginal integrity in vitro. The patient had an uneventful postoperative recovery. Atesok K, Doral MN, Whipple T, et al. Lateral Femoral Condyle (LFC) osteochondral fracture (HSL, Hill-Sachs-like Lesion) can be seen in 30 of knee flexion. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. 2001;17:5425. Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. official website and that any information you provide is encrypted Cureus 2016;8:e802. [10] Werner and Miller[11] reported that iatrogenic injury is a cause of Hoffa fracture that cannot be ignored. FOIA Osteochondral injuries of the knee in pediatric patients. [82,83] A biomechanical study by Li et al[84] demonstrated that plates combined with screws more firmly fixed the femoral condyle, reducing the probability of fracture displacement. This approach fully exposes the fracture and does not risk damaging the nerves and blood vessels,[67] making the operation simple and safe. The weight-bearing joints such as the knee, hip, and ankle joints are more commonly affected. Internal fixation with headless compression screws and back buttress plate for. Lewis SL, Pozo JL, Muirhead-Allwood WF. [Patella infera. Bilateral. A patella that is stuck between the tibia and femur can be relocated naturally by flexing of the hip joint with the knee in 110 of flexion under local anesthesia. 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. 5cm cartilage mass was stripped from nonweight-bearing area of the LFC, and no osteochondral mass was found at the medial edge of patella (Fig. Ji G, Wang S, Wang X, et al. Chauhan A. Irreducible, incarcerated vertical dislocation of the patella into a. Factors of patellar instability: an anatomic radiographic study. Intra-articular dislocation of the patella with associated, [26]. 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. [33] Dua and Shamshery[34] proposed a classification method that supplements the AO classification with proper surgical planning to optimize outcomes. You may be trying to access this site from a secured browser on the server. Arthroscopic reduction and internal fixation of a displaced intraarticular lateral femoral condyle fracture of the knee. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures. The white arrow indicate the defect area. Cancellous screws cannot achieve adequate compression[55] and require more surgical time to countersink. Nondisplaced Hoffa fractures can be treated with cylindrical plaster cast immobilization with the knee in 10 of flexion. (D) Under knee arthroscopy, obvious fracture line of lateral condyle of bone and osteochondral fracture of the lateral femoral condyle can be seen. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. [33]. The functional and radiographic outcome were satisfactory at 18 months after operation. Lian and Zeng[85] and Zhao et al[86] treated Hoffa fracture patients with plates combined with screws and achieve good results. [10]. During the operation, 2 4.5mm anchor (Smith @ nephew TIWNFIX Ultra PK Suture Anchor) was inserted into the posterior edge and medial edge of the cartilage mass in the weight-bearing area, and then 2 non-absorbable sutures on each anchor were replaced by an absorbable suture (ETHICON VICRYL PLUS VCP359H), and finally the 2 ends of the absorbable suture were knotted to prevent sliding. Knee Surg Sports Traumatol Arthrosc. (C) Making a small incision on the outside of the knee joint, it is convenient to drill two 2.0mm bone channels from the distal end of the femur from the outside to the intercondylar fossa. The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request. A fracture is a broken bone. Braune C, Rehart S, Kerschbaumer F, Jger A. In general, there has been a trend toward . [82]. Friederichs et al[24] reported cases of opposing articular surface cartilage injury caused by bioabsorbable screws, which required second operation. Arthroscopy 1996;12:2247. Transverse Hoffas or deep. The patient was referred to an or- thopaedic surgeon, who recommended conservative management. Ozturk A, Ozkan Y, Ozdemir RM. Starr AJ, Jones AL, Reinert CM. Before Technique of reduction and fixation of unicondylar medial, [70]. 3). This article discusses anatomic considerations, classification of condylar fractures, indications for surgery, treatment options, and complications. For local soft-tissue injuries, external fixation can be used, but this may delay the time to mobility restoration and affect therapeutic efficacy. [5]. [93]. You may search for similar articles that contain these same keywords or you may [7] Nondisplaced Hoffa fractures are difficult to visualize on anterior and lateral radiographs of the knee. Med Sci Monit, 2012, 18: CS117CS120. Biau DJ, Schranz PJ. J Knee Surg. Knee Surg Sports Traumatol Arthrosc. Would you like email updates of new search results? Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. modify the keyword list to augment your search. [83]. [18]. Egol KA, Broder K, Fisher N, et al. [92]. [22]. Li et al[25] used absorbable suture to treat OCF caused by patellar dislocation and achieved good medium-term results. For simple fractures of the medial condyle, a medial parapatellar surgical approach is most commonly used. 2021;13(1_suppl):966S73S. Bethesda, MD 20894, Web Policies Fracture surgery complications include: Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage. [40]. However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. Background The goal of this present study was to precisely determine the dimension and location of the impaction fracture on the lateral femoral condyle in patients with an ACL rupture. Werner BC, Miller MD. [1] A Hoffa fracture, a rare fracture confined to the coronal plane of either femoral condyle, accounts for 8.7% to 13% of distal femoral fractures. Vaishya R, Singh AP, Dar IT, et al. 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. Fracture and dislocation compendium: Orthopaedic Trauma Association Committee for Coding and, [35]. [16]. Objective: To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. [30]. Search for Similar Articles Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Plain radiograph The .gov means its official. Report of 20 cases [in French]. 2023 Jan;15(1):103-110. doi: 10.1111/os.13586. J Bone Joint Surg Am 2006;88:22704. Active and passive knee flexion exercise of the right knee was gradually strengthened 6 weeks after operation. This is the first report on a fracture of medial femoral condyle treated with this implant. Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws. Orthop J Sports Med. In contrast, type II fractures have a high risk of nonhealing or delayed healing because of poor adhesion and poor blood supply. (C) CT examination of the left knee joint: the continuity of the subarticular bone of the lateral condyle of the left femur was interrupted. d Department of Orthopedic Surgery, Second Peoples Hospital of Yuhang District, Hangzhou, Zhejiang, China. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. During complete anterior cruciate ligament (ACL) tears in pivoting mechanisms, the area of the lateral femoral condyle (LFC) localized just above the anterior third of the lateral meniscus (LM) impacts the posterior border of the lateral tibial plateau (LTP), which may result in a subchondral compression fracture. Based on plate position, screws can be combined with a lateral antigliding plate[84] or a posterior antigliding plate.[55,87]. -, Morris John K, Weber Alexander E, Morris Mark S. Adolescent femoral chondral fragment fixation with polyLlactic acid chondral darts. Pure lateral blow-out fractures are rare, as the bone is thick and bounded by muscle. Plate fixation for Letenneur type I. J Trauma 2000;48:15960. 1). Onay T, Glabi D, olak , et al. 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. View Large Image Download Hi-res image Download (PPT) At present, open reduction is often used to treat osteochondral fractures. J Orthop Trauma 2006;20:2736. Bioactive factors for cartilage repair and regeneration: improving delivery, retention, and activity. Acta Orthop Scand 1997;68:4246. Moreover, even if the medial patellar retinaculum is strengthened, the patient still has symptoms such as anterior knee pain. Iwai T, Hamada M, Miyama T, et al. Antigliding plating for Letenneur type I Hoffa fractures. Wang JY, Liu Y, Li Y, et al. Postoperative reexamination of computed tomography scan showed that the bone block was well reduced. This sign represents a severe bone contusion caused by impression, and microfracturing, visible on MRI, and is suspect for an impacted (osteo)chondral fracture due to a tear of . 2020 Jun 15;9 (6):e823-e828. Conjoint bicondylar, [22]. Ostermann PA, Neumann K, Ekkernkamp A, et al. impacted and stress fractures. Osteochondral fractures of the lateral, [11]. However, some patients had suture removal during the second arthroscopy because of suture irritation. Intertrochanteric femoral fractures occur mostly in the elderly, and the average age of onset is 66-76 years. [10]. Monocondylar fractures of the femur: a review of 13 patients. At the same time, forces on the distal tibia are transferred to the tibial plateau, resulting in great shear stress between the femoral condyle and the tibial plateau. Surgically treated Hoffa Fractures with poor long-term functional results. The bone contusions on the lateral femoral condyle, lateral aspect of the tibial plateau, medial femoral condyle, and medial aspect of the tibial plateau were documented. [102]. [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. findings identifies vascular segments with diminished flow vascular injury (C) The free edge of the anterior foot of the meniscus was rough (degree I). [90]. classification; diagnosis; Hoffa fracture; injury mechanism; treatment. [7]. [102] Therefore, open reduction and internal fixation is recommended to minimize cartilage damage and allow appropriate treatment of the bone and soft tissues. Shah JN, Howard JS, Flanigan DC, et al. Callewier et al[23] reported a patient who used absorbable pin fixation to treat OCF in the weight-bearing area of LFC. [1,2] However, most LFC cartilage injuries are located in the anterior non-weight-bearing area. J Pediatr Orthop. Introduction. [59]. [64]. Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report. [104]. [99] The patella may become incarcerated in the intercondylar fossa, wedged between the femoral condyles, or even rarely incarcerated in the Hoffa fracture. Appointments 216.444.2606. The natural history. may email you for journal alerts and information, but is committed Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. Malunion: This happens when your broken bones don't line up correctly while they heal. Data is temporarily unavailable. The tears of the lateral meniscus and medial meniscus were detected during arthroscopy. Studies by Gesslein et al[22] show that open reduction and internal fixation of LFC with OCF is better than loose body removal. 2). Some error has occurred while processing your request. Making the diagnosis of a Hoffa fracture is challenging. The distal femur is where the bone flares out like an upside-down funnel. After arthroscopic confirmation of Lateral Femoral Condyle (LFC) ostechondral fracture (HSL, Hill-Sachs-like Lesion) the anterolateral portal is enlarged to 2-3 cm. Khle J, Angele P, Balcarek P, et al. 1 It has been proved that compression of the posterior border of . Anatomic reduction of the articular surface, stable fixation, and early mobilization should be the aims of treatment. Three days after injury, the lateral parapatellar incision of the right knee was performed under general anesthesia, OCF reduction and fixation of the lateral condyle was performed. A comparison of the clinical effect of two fixation methods on Hoffa fractures. Malays Orthop J 2017;11:204. Methods All patients with post-injury bi-plane radiographs and MRI images after sustaining a tear to the anterior cruciate ligament were included. [100,101] To avoid damaging the cartilage in these cases, it is important to reduce the patella early and restore the patellofemoral joint stability by repairing the damaged medial soft tissues. The authors have no conflicts of interest to disclose. Gang et al[20] found that there was no statistically significant difference between surgical treatment and non-surgical treatment in patients with patellar side injury of medial collateral ligament of patella. Xray examination of right knee joint: free bone mass can be seen at the anterior edge of the femur in the knee joint. [8]. [95]. Primary traumatic patellar dislocation. In such cases, the forces necessary for closed reduction can result in cartilage injury or a small avulsion fracture of the patella. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. [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. Hoffa fractures are most commonly caused by traffic accidents, especially motorcycle accidents. (B) The suture of the lateral condyle of the femur is still fixed on the surface. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. 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. [73] This approach is suitable for the treatment of Hoffa fracture with patella dislocation. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Min L, Tu CQ, Wang GL, et al. [2]. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. Sagittal MRI images were reexamined 18 months after operation, MRI = magnetic resonance. This study aimed to systematically review the clinical knowledge base of Hoffa fractures to facilitate the diagnosis and management of such injuries. Abstract Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. Soraganvi PC, Narayan Gowda B, Rajagopalakrishnan R, et al. modify the keyword list to augment your search. [Resorbable pin refixation of an osteochondral fracture of the lateral femoral condyle due to traumatic patellar dislocation: case management, follow-up and strategy in adolescents]. The incidence ratio in male and female patients is in the range . (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. Wolters Kluwer Health The advantage of this approach is that it does not compromise future arthroplasty surgery; however, it does not allow visualization and treatment of any posterior comminution. Gelber PE, Erquicia J, Abat F, et al. Received: 27 October 2022 / Received in final form: 8 November 2022 / Accepted: 9 November 2022. If fractures are present they are usually associated with orbital rim or other significant craniofacial injuries. Mootha AK, Majety P, Kumar V. Undiagnosed, [11]. Xu Y, Li H, Yang HH, et al. 2017;30:37884. 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. Wu, Liang MMa; Liu, Chao BMb; Jiang, Bing BMc; He, Lijiang MMd,*, a Department of Orthopedic Surgery, First Peoples Hospital of Linpin District, Hangzhou, Zhejiang, China, b Department of General Surgery, Medicine Faculty of Universitas Prima Indonesia, North Sumatra, Indonesia, c Department of General Surgery, Daocheng Country Peoples Hospital, Sichuan, China. Dave LY, Nyland J, Caborn DN. After the osteochondral mass was fixed in situ to the lateral condyle of the femur, 2 suture ends of the posterior suture anchor penetrate into the front bone tunnels respectively, and after penetrating from the LFC, they are knotted and fixed with 2 suture ends of medial suture anchor respectively (Fig. Liebergall M, Wilber JH, Mosheiff R, et al. Papadopoulos AX, Panagopoulos A, Karageorgos A, et al. Kondreddi V, Yalamanchili RK, Ravi Kiran K. Bicondylar Hoffa's fracture with patellar dislocation - a rare case. A patient, 15-year-old, female student. On lateral radiographs, the normal femoral condyles overlap, and bone cortex interruption may not be visible. Please enable scripts and reload this page. Chin J Traumatol 2011;14:1436. Tsai CH, Hsu CJ, Hung CH, et al. Allmann KH, Altehoefer C, Wildanger G, et al. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . -. The knee joint is placed in flexion during surgery,[65,66] placing the joint capsule and gastrocnemius in a relaxed state, which reduces the traction on the fracture and is conducive to fracture repair. Maenpaa H, Huhtala H, Lehto MU. 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. J Bone Joint Surg Am 1974;56:4234. Potini VC, Gehrmann RM. Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. [20]. 2012;40:191623. [48]. Introduction. Impact fractures are due to track formation and propagation. Operative, [46]. Moreover, the placement of a posterior antiglide plate with screws strips more soft tissue, especially the insertion of the gastrocnemius heads, and may destroy the blood supply to the fragments. The https:// ensures that you are connecting to the Impact fractures can be classified either as ductile or brittle depending on the elongation pattern that is present. Management of any globe injury generally takes precedence over fractures 1. ;Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. [16]. [51]. [9]. Arthroscopic. After 1 year follow-up, good functional and radiographic outcome were obtained. 1). Li R, Guo G, Chen B, Zhu L, Lin A. Arthroscopicallyassisted reduction and fixation of an old osteochondral fracture of the lateral femoral condyle. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. An appropriate surgical approach allowing full fracture exposure is selected based on fracture type. Arthroscopy. Nandy K, Raman R, Vijay RK, et al. 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%. A case report. Bartonicek J, Rammelt S. History of femoral head fracture and coronal fracture of the femoral condyles. Published by Wolters Kluwer Health, Inc. Soni A, Sen RK, Saini UC, et al. The main cause of a Hoffa fracture is a high-energy injury such as those sustained in traffic collisions (80.5% of cases) and falls (9.1% of cases). National Library of Medicine The authors have no funding and conflicts of interest to disclose. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. [25] Loss of bone matrix results in brittle, weaker bones that break rather than bend with external force. [50]. Cheng S, Zaidi SF, Linnau KF. [43]. [104] To prevent habitual patellar dislocation, repair of the medial retinaculum complex or a combination of lateral retinacular release[14,105] and simultaneous patellar ligament insertion on the tibial tubercle is recommended. Summary Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Two bone tunnels are made from anteromedial to posterolateral with 2mm Kirschner wire at the front edge of osteochondral mass. [78]. Dejour H, Walch G, Nove-Josserand L, et al. A mechanical evaluation of two fixation methods using cancellous screws for coronal fractures of the lateral condyle of the distal femur (OTA type 33B). Sharath RK, Gadi D, Grover A, et al. Vivek T, Saubhik Da, Sahil G, et al. Non-union coronal fracture femoral condyle, sandwich technique: a case report. Familiarity with the characteristics of Hoffa fracture on various imaging modalities and an understanding of the mechanism and likelihood of combined injuries contribute to the timely and accurate diagnosis of Hoffa fracture and avoiding misdiagnosis. 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.
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