Hoffa fracture

Definition

 

Coronal plane fracture of distal femoral condyle

- intra-articular

- often only attachment is posterior capsule

 

Epidemiology

 

Rare

 

Mechanism

 

Usually a severe valgus trauma

 

Xray

 

Usually lateral femoral condyle

 

Hoffa Fracture Xray

 

CT / MRI

 

CT

- aids surgical planning

 

MRI

- excludes associated LCL / MCL injury

 

Hoffa Fracture MCL Avulsion MRI 1Hoffa Fracture MCL Avulsion MRI 2

 

Management

 

Issue

 

Usually unstable

- needs ORIF

- can be associated with LCL injuries

 

Must preserve the posterior soft tissue for vascularity

 

Options

 

1.  Buttress screws + AP screws

 

Hoffa Fracture ORIF APHoffa Fracture Lateral

 

2.  Headless compression 6.5mm PA screws

 

Hoffa Fracture ORIF PA screws