Hoffa s Fracture Case Report

Case Report

Austin J Orthopade & Rheumatol. 2023 ; 10(2) : 1120.

Hoffa’s Fracture Case Report

Abdelhay Rabah*

Department of Orthopedic A Traumatological Surgery, Mohamed V Military Hospital, Rabat-Morocco

*Corresponding author: Abdelhay Rabah Department of Orthopedic A Traumatological Surgery, Mohamed V Military Hospital, Rabat-Morocco. Email: rabahabdelhay7@gmail.com

Received: September 27, 2023 Accepted: November 02, 2023 Published: November 09, 2023

Abstract

Unicondylar fractures of the distal third of the femur in the coronal plane are known as Hoffa’s fractures, they are rare and very rare. Few cases have been reported of this type of fracture, by definition they are unstable fractures and therefore require surgical treatment. The mechanism of trauma in this type of fracture is direct with the knee in flexion. Often they can go unnoticed in the Anteroposterior (AP) X-ray projection, which is why it is important to assess the lateral projection. When they are suspected or highlighted, it is necessary to pass a Computed Tomography (CT) in order to clearly define its surgical resolution, since the approach and method of fixation are controversial. Although today the availability and characteristics of different types of implants have increased, there is no consensus in the literature mainly due to the lack of expertise in these rare cases.

Introduction

Hoffa's fracture, first described in 1904 [1], is a rare type of fracture of the femoral condyle with its unique coronal cut. Lateral Hoffa fractures are more common, but medial Hoffa fractures have been described and are extremely rare. This type of fracture is intra-articular by definition and the principles of treatment are generally similar to those of typical intra-articular fractures. Moreover, this type of injury often goes unnoticed due to lack of clinical suspicion and inadequate radiographic imaging [2]. The mechanism of injury is usually high velocity energy [3–6]. Here we present a case of a 25-year-old patient with a rare type of injury involving the lateral femoral condyle; surgically treated by open reduction and internal fixation.

Clinical Observation

This is a young soldier who presented to our emergency services with right knee pain and total functional impotence of the right lower limb following a road accident collision between 2 motorcycles with landing on the knee right. Clinical examination revealed that his knee was enlarged with tight skin and peri-patellar bruising with no skin opening and range of motion was limited due to pain. Neurovascular examination was normal with no signs of compartment syndrome. Knee x-rays revealed a lateral Hoffa fracture (Figure 1).