Please enable it to take advantage of the complete set of features! 4). [19]. Liebergall M, Wilber JH, Mosheiff R, et al. 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. J Orthop Surg Res 2012;7:21. Jabalameli M, Bagherifard A, Hadi H, et al. The natural history. Dave LY, Nyland J, Caborn DN. 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. [39,40] Wagih[41] reported that, under general anesthesia, patients with Hoffa fracture have instability at 30 of flexion but not with leg straightened. [33] Dua and Shamshery[34] proposed a classification method that supplements the AO classification with proper surgical planning to optimize outcomes. We do not do patellar medial collateral ligament repair to reduce complications such as knee joint adhesion. Baker BJ, Escobedo EM, Nork SE, et al. At present, open reduction is often used to treat osteochondral fractures. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. ASER Core Curriculum Illustration Project: coronal femoral condyle (Hoffa) fracture. 2013;33:5118. If fractures are present they are usually associated with orbital rim or other significant craniofacial injuries. 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. Federal government websites often end in .gov or .mil. Skeletal Radiol 2015;44:3743. The swashbuckler: a modified anterior approach for fractures of the distal femur. 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). Incarcerated patellar tendon in. [25] Loss of bone matrix results in brittle, weaker bones that break rather than bend with external force. Studies by Gesslein et al[22] show that open reduction and internal fixation of LFC with OCF is better than loose body removal. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. Lee SY, Niikura T, Iwakura T, et al. [102]. 2023 Jan;15(1):103-110. doi: 10.1111/os.13586. Hoffa's fractures. You may be trying to access this site from a secured browser on the server. Keyword Highlighting absorbable internal fixation; dislocation of patella; femoral condyle; osteochondral fracture. Anatomic reduction of the articular surface, stable fixation, and early mobilization should be the aims of treatment. After 1 year follow-up, good functional and radiographic outcome were obtained. Some error has occurred while processing your request. For tibial fractures, the use of bone plates or intramedullary nails is recommended if the condition of the local soft tissue is suitable. Through the lateral parapatellar approach, we reduced the osteochondral mass and bundled it with absorbable sutures of anchors. [Treatment of extensive chondral defects of the patella after patellar dislocation]. The tears of the lateral meniscus and medial meniscus were detected during arthroscopy. A modified posterolateral approach for. Irreducible, incarcerated vertical dislocation of patella into a. 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. Partial weight bearing with crutches is started at 6 to 8 postoperative weeks. Sharath RK, Gadi D, Grover A, et al. Injury 2015;46:41921. We used the key words Hoffa fracture and coronal fracture of femoral condyle for the knowledge. Springerplus 2016;5:1164. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. Unicondylar femoral fractures: therapeutic strategy and long-term results. 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. Management of any globe injury generally takes precedence over fractures 1. [25]. One hundred five relevant articles were reviewed, and the clinical knowledge base was summarized. The injury to MCL was also observed with MRI. Vivek T, Saubhik Da, Sahil G, et al. Intertrochanteric femoral fractures occur mostly in the elderly, and the average age of onset is 66-76 years. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. Malays Orthop J 2017;11:204. 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. [7,10] The finding of medial or lateral stress test and anterior and posterior drawer test were reported to be positive in some patients. In the type II (bicondylar Hoffa fracture), both condyles are fixed with anteroposterior screws. [10] Some of these patients may have a history of poliomyelitis that predisposes individuals to osteoporosis. J Orthop Trauma 2002;16:17881. (B) 1.5cm1.5cm free bone was found in the knee joint cavity, and the bone fracture was intact. 2007 Oct;23(10):1133.e1-4. Braune C, Rehart S, Kerschbaumer F, Jger A. Published by Wolters Kluwer Health, Inc. Osteochondral injury to the mid-lateral weight-bearing portion of the lateral, [14]. 0cm osteochondral mass was stripped from the weight-bearing area of the LFC, 2.0*0. If radiographic findings are negative in questionable cases, CT and magnetic resonance imaging (MRI) should be performed. Rofo. 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. In recent years, with the development of arthroscopy, we have been able to complete the reduction and internal fixation of fractures under arthroscopy. your express consent. [92]. Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report. Wang JY, Liu Y, Li Y, et al. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. [39]. The use of several 3.5-mm-diameter screws is recommended to fix the fractures. Gerdy's tubercle osteotomy for the, [69]. Distal femur fractures most often occur either in older people whose bones . With a lower degree of knee flexion, the extensor mechanism is damaged below the patella (patellar tendon); at higher angles, the quadriceps tendon is torn. (LTC, Lateral Tibial Condyle.) Li R, Guo G, Chen B, Zhu L, Lin A. Arthroscopicallyassisted reduction and fixation of an old osteochondral fracture of the lateral femoral condyle. [105]. Cancellous screws cannot achieve adequate compression[55] and require more surgical time to countersink. For bicondylar Hoffa fractures, it is necessary to simultaneously expose both condyles[71] to allow proper reduction. . Rev Chir Orthop Reparatrice Appar Mot. You will need surgery to repair your bone, and recovery can take a year or longer. This method is beneficial for reducing small and rotating fragments. [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. Published by Wolters Kluwer Health, Inc. Repair of displaced partial articular fracture of the distal femur: the. 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. A rare case of unicondylar medial, [24]. 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. [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]. Manfredini M, Gildone A, Ferrante R, et al. Smith EJ, Crichlow TP, Roberts PH. [47]. 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. [33]. Palmu S, Kallio PE, Donell ST, et al. (B) The sutures passing through the bone canal and the corresponding sutures on the anchor were tightened and fixed. [43]. 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. For more information, please refer to our Privacy Policy. After operation, the fracture of femoral condyle healed well and the function of knee joint recovered gradually. [78]. Bicondylar. Matthewson et al[10] believe OCF in weight-bearing area of LFC with patellar dislocation is caused by the shearing forces between the LFC and the lateral tibial plateau as they pivot under load. 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 [100]. [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. [89]. [76]. [17]. -, Patel JM, Saleh KS, Burdick JA, Mauck RL. Apropos of 128 cases]. may email you for journal alerts and information, but is committed Your message has been successfully sent to your colleague. Viskontas DG, Nork SE, Barei DP, et al. Arthroscopy 1996;12:2247. Non-union coronal fracture femoral condyle, sandwich technique: a case report. Two bone tunnels are made from anteromedial to posterolateral with 2mm Kirschner wire at the front edge of osteochondral mass. Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. Dhillon MS, Mootha AK, Bali K, et al. (A) The fresh 1.5cm1.5cm fracture surface of the lateral condyle of femur was found under arthroscopy. [20]. Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Musculoskelet Surg 2012;96:4954. See this image and copyright information in PMC. Guo H, Chen Z, Wei Y, Chen B, Sun N, Liu Y, Zeng C. Orthop Surg. [10] Werner and Miller [11] reported that iatrogenic injury is a cause of Hoffa fracture . Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. Surgery for patellar dislocation has evolved towards anatomical reconstructions with assessment and treatment of anatomical risk factors. J Knee Surg. 3). Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. Khle J, Angele P, Balcarek P, et al. 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.
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