Hoffa fractures classification

PURPOSE: Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress...

INTRODUCTION: Hoffa fractures are a rare and often overlooked entity. The main goal of surgical treatment is to restore the articular surface and maintain knee function. However, current clinical data indicate heterogeneous outcomes. The aim of this multicenter study was to obtain a representative data set of patients with isolated Hoffa fractures with special emphasis on concomitant soft tissue injuries, diagnostic algorithms, treatment strategies and functional outcomes. MATERIALS AND METHODS: Participating Level I trauma centres were asked to review their internal database for isolated Hoffa fractures treated surgically between 2010 and 2020...

BACKGROUND: Accomplish a thorough review on the existing biomechanical and clinical studies about coronal plane fractures of the distal femur. METHODS: We performed an electronic search of PubMed/MEDLINE database from April to June, 2023. The terms for the database search included "Hoffa fractures," OR "Busch-Hoffa fractures" OR "coronal plane fractures of the distal femur." RESULTS: The search identified 277 potentially eligible studies. After application of inclusion and exclusion criteria, 113 articles were analyzed in terms of the most important topics related to coronal plane fractures of the distal femur...

OBJECTIVE: The posterior coronal shearing fractures of the tibial plateau are rare and can be easily missed or ignored. Our team defined these fractures as Hoffa-like fracture of the tibial plateau and conducted a series of studies. The aim of this study is to introduce the characteristics of the Hoffa-like fracture of the tibial plateau, propose a new classification system and evaluate its validity. METHODS: Sixty-one patients with Hoffa-like fractures of the tibial plateau were treated in five trauma centers (I-III) from 2017 to 2020...

BACKGROUND: To evaluate the feasibility and clinical effect of the suture anchor combined with external fixation in the treatment of the lateral femoral condyle Hoffa fracture. METHODS: In this study, a retrospective study was conducted to analyze the feasibility of treating fourteen patients (eight men and six women) with Hoffa fractures admitted to our Hospital from January 2016 to October 2021 with combined external fixation using incisional reduction anchor nailing...

BACKGROUND: A Hoffa fracture is an unstable intra-articular break that is generally treated with surgery. OBJECTIVE: To evaluate the feasibility and clinical outcomes of using a suture anchor combined with auxiliary fixation for the treatment of a lateral femoral condyle Hoffa fracture. METHODS: The study retrospectively reviewed 8 patients (5 males and 3 females) with a lateral femoral condyle Hoffa fracture who had been treated by combining a suture anchor with auxiliary fixation between January 2016 and April 2020...

INTRODUCTION: A Hoffa fracture is a rare coronal plane, intra-articular fracture of the femoral condyle involving the weight-bearing portion of the posterior distal femur. The anatomy of this fracture lends it to be an inherently unstable injury, requiring surgical fixation to achieve stability. To date, research describing Hoffa fractures is limited to small case series and case reports. This article aims to describe the first case discussion of a unique type of Hoffa fracture with a sagittal split within the fragment and intra-articular comminution...

INTRODUCTION: Lateral Hoffa nonunion are rare injuries. A significant percentage of these nonunions are due to missed acute lateral Hoffa fractures. Operative management of these injuries is difficult and complicated by the presence of bone loss, infection, and soft-tissue contractures. In this study, the aim was to assess clinical and functional outcome in our group of patients with lateral Hoffa nonunion who had undergone operative management and to determine whether variables such as fracture type, infection, and previous surgery affect nonunion/complication rates...

The Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized...

Unicondylar fractures of the femur are uncommon injuries that can occur in the sagittal or, less frequently, in the coronal plane (Hoffa fractures).  Distal femoral fractures are usually described following the AO/OTA Classification system which includes extra-articular, partial articular and intra-articular injuries, further divided in three types based on the pattern and comminution.  Accurate reduction and stable fixation are needed especially in articular injuries in order to allow early mobilization and reduce complications such as knee stiffness, malunion or secondary osteoarthritis...

Objective: To investigate the effectiveness of the extended Carlson approach in the treatment of lateral femoral condylar Hoffa fractures. Methods: The clinical data of 17 patients with lateral femoral condyle Hoffa fractures between September 2012 and January 2019 were retrospectively analyzed. There were 10 males and 7 females, with a mean age of 43 years (range, 32-68 years). Fractures were caused by traffic accident in 9 cases, by falling from height in 6 cases, and by the other mechanism in 2 cases...

Background: Correct management of Hoffa fractures is a challenge in the clinical context. Open reduction along with internal fixation should be the therapy of choice. Mechanical trials with the main internal fixation systems conducted by individualized finite element (FEM) models, to date, have been neglected. The aim of this study was to biomechanically analyze four fixation methods for the treatment of Type II Hoffa fracture (OTA Classification: 33B3.2∗ lateral) using FEM. Methods: Four internal fixators were developed to treat Type II Hoffa fracture using finite elements: 4...

PURPOSE: This study aims to present a novel classification system and a rationale for treatment of medial Hoffa fractures. METHODS: We developed a simple comprehensive classification system for medial Hoffa fractures based on the fragment size and presence of fracture comminution. Furthermore, we propose a treatment algorithm based on two pillars: our case series of nine patients presenting medial Hoffa fractures and the best evidence-based pertinent literature...

Introduction: Isolated fracture of femoral condyle in the coronal plane (Hoffa fracture) is rare and surgically challenging to treat. The purpose of this study is to introduce a new classification for this fracture, evaluating its utility in treatment guidelines and its reproducibility. Materials and methods: 103 patients with Hoffa fracture were operated in our tertiary care centre from 2004 to 2014. Computed tomography (CT) was done in all cases preoperatively...

BACKGROUND: Coronal fractures of distal end femur, referred as Hoffa's fracture are not uncommon, yet easily missed injuries lacking proper classification system and consensus for ideal treatment. While most trauma surgeons adopt different strategies based on the fracture configuration and their own experience, there are no set ways to classify these based on the most appropriate treatment strategy. METHODS: Thirty cases of Hoffa fracture from tertiary care centres were studied for the fracture pattern, fragment size, comminution and possible variations to formulate a radiological classification and treatment guidelines...

Introduction: Proximal tibia intra-articular fractures are commonly associated with ligamentous injuries and require early diagnosis and intervention. An array of fracture patterns can be encountered, and Schatzker's classification is a standard description to identify them. However, several patterns have been described that fall outside the ambits of this classification. We present a rare fracture pattern of partial posteromedial condyle coronal split associated with depression of the anterolateral plateau and mid substance tear of medial collateral ligament (MCL) and avulsions of anterior and posterior cruciate ligaments(ACL/PCL)...

BACKGROUND: Hoffa fractures are coronal-plane fractures of the femoral condyle, which are rarer than sagittal-plane condylar fractures. This study aimed to systematically review the clinical knowledge base of Hoffa fractures to facilitate the diagnosis and management of such injuries. METHODS: We searched Medline, Embase, Cochrane Library, Google Scholar, China National Knowledge Infrastructure, and China Biology Medicine disc, using the terms "Hoffa fracture" and "coronal fracture of femoral condyle...

Treatment of distal femur fractures in the coronal plane can be challenging. Depending on fracture line orientation, topography and associated comminution, decision-making regarding approach and fixation is not straightforward and can result in complications. Therefore, treatment of coronal plane distal femur fractures (Busch-Hoffa fractures) should be approached in a systematic manner, leading to efficient planning and operative execution. Here, we offer a proposed treatment algorithm, guiding treatment, approach and fixation based on the modified Letenneur classification of coronal plane distal femur fractures...

Hoffa fracture is a rare type of fracture confined to the coronal plane of the femoral condyle. High-energy is a common reason of Hoffa fracture, and low-energy trauma and iatrogenic injury can also cause Hoffa fracture in some cases. The commonly used classifications include Letenneur classification, CT classification, AO classification and modified AO classification. X-ray is the first choice to diagnose Hoffa fractures, fracture lines can be found. If the X-ray is negative, CT scan and MRI should be performed...

In this report, we present a case of an uncommon coronal fracture of the femoral condyle, known as a Hoffa fracture. Classification of these injuries and commonly associated injuries are discussed. We describe previously proposed mechanisms of injury and review the current literature. The difficulty in establishing radiologic diagnosis on the basis of radiography exclusively is emphasized. Finally, current approaches to operative fixation are outlined.