Treatment of Hoffa fractures / 中华创伤骨科杂志

ABSTRACT

Objective To investigate clinical characteristics and treatment of Hoffa fractures.Methods Twenty patients with Hoffa fracture (24 condyles) were treated from January 2002 to April 2009.They were 14 men (18 condyles) and 6 women (6 condyles), aged from 20 to 70 years (average, 43. 3 years).There were 15 fractures of medial femoral condyle and 9 ones of lateral femoral condyle. Two rare cases were fractures of unilateral bi-condyles and one rare case fractures of unilateral bi-condyles plus contralateral single condyle. Four fractured condyles were old due to implant failure and 20 were fresh. According to the modified Letenneur's classification, there were 6 condyles of type Ⅰ, 4 condyles of type Ⅱ and 14 condyles of type Ⅲ.Fifteen condyles were fixed anteroposteriorly with 2 to 4 cancellous or canulated screws, 8 condyles were fixed posteroanteriorly with 2 to 4 screws, and one condyle was fixed with K wires. Five condyles were fixed with screws plus lateral supporting plates, and 3 condyles with screws plus posterior anti-sliding plates. Results All the patients were followed up for an average of 14. 4 months (6 to 84 months) . All the 24 condyles obtained bony union after an average of 18. 6 weeks (from 12 to 44 weeks). There was no infection, implant failure, nonunion or bone necrosis. According to Letenneur's functional assessment system, 16 condyles were excellent, 6 good and 2 poor, with a good-to-excellent rate of 91. 7%. Conclusions All Hoffa fractures should be treated with screws. Screw diameter, fixation direction and surgical incision should depend on facture type and size of fracture block. Unstable Hoffa fractures should be treated with screws combined with lateral supporting plates or posterior anti-sliding plates.