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Hoffa Fracture in Childhood

Blagovest Belchev, Konstantin Ganchev, Yosif Gerchev, Preslav Penev

Abstract

Introduction: Coronal fractures of the femoral condyle, first described by Hoffa in 1904, are an uncommon clinical entity typically seen in adults after higher-energy trauma. These fractures appear to be even more uncommon in children. A young boy presented after sustaining a twisting injury to his left knee. He presented shortly thereafter to the emergency room with a swollen, painful left knee and inability to bear weight. Physical examination revealed a diffusely tender knee with a moderate-sized effusion. He reported significant pain with any type or range of motion. Anterior and lateral radiographs of the knee revealed a hemarthrosis with a minimally displaced fracture to the lateral femoral condyle. Computed tomography scan revealed a minimally displaced coronal shear fracture of the lateral femoral condyle. The patient was placed in a bulky soft dressing and knee immobilizer, and underwent open reduction and internal fixation. Hoffa fractures are a unique and uncommon clinical entity that has a different personality than other intra articular fractures of the knee in children. In contrast to adults, these fractures appear to be associated with lower-energy mechanisms in skeletally immature patients.

Materials and Methods: The patient underwent surgical treatment. It was made with open reduction internal fixation done with 2 screws using anterior approach.

Results: After undergoing rehabilitation,  the patient recovered full mobility and functionality of the joint for a period of 30 to 35 days. 

Conclusion: Hoffa fracture in childhood needs to be treated surgically with open reduction internal fixation in most of the cases by using cannulated screws or Herbert screws


Keywords

Hoffa fracture, ORIF


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