Clinical features and surgical treatment of Hoffa fractures
Author(s): WANG Yong, JIANG Jiannong, WANG Qiang, ZHANG Leiyan, JIANG Haiping, MENG Weichun, HAO Sichun, ZHANG Panjun, WU Chenguang
Pages: 122-127
Year: 2014 Issue: 2
Journal: Chinese Journal of Trauma
Keyword: Femoral fractures; Fracture fixation; internal; Bone screws;
Abstract: Objective To summarize the clinical features of Hoffa fractures and to investigate the surgical strategies and curative effect.Methods The study enrolled 18 patients with Hoffa fractures treated from January 2007 to December 2011.All the patients were male,at a mean age of 36.8 years (range,18-58 years).There were 17 patients with fresh fractures and 1 with old fracture nonunion.Lateral condylar fractures occurred in 8 patients and medial condylar fractures in 10.According to Letenneur' s classification,9 fractures were type Ⅰ,3 type Ⅱ and 6 type Ⅲ.Open reduction and internal fixation was performed,including 13 patients being fixed with 2-3 cannulated screws of 4.5 mm via anterior approach and 5 patients with 2-4 headless compression screws of 2.4,3.0 or 4.0 mm via posterior approach.Results Three patients were misdiagnosed at the first visit with a missed diagnosis rate of 17％ (3/18),but were later confirmed in CT scanning.Fourteen patients were followed up for a mean period of 24 months (range,12-60 months),with bony healing in average 12 weeks (range,8-24 weeks).There were no complications of infections,deep vein thrombus,reduction loss,or implant failure.According to Letenneur' s assessment system,the outcome was excellent or good in 11 patients,fair in 2,and poor in 1.Conclusions Early anatomical open reduction and rigid internal fixation are key to successful treatment.Surgical approaches and types,diameters as well as entry directions of screws should be determined with reference to the fracture type,size of fracture fragment and presence or absence of comminution.
Pages: 122-127
Year: 2014 Issue: 2
Journal: Chinese Journal of Trauma
Keyword: Femoral fractures; Fracture fixation; internal; Bone screws;
Abstract: Objective To summarize the clinical features of Hoffa fractures and to investigate the surgical strategies and curative effect.Methods The study enrolled 18 patients with Hoffa fractures treated from January 2007 to December 2011.All the patients were male,at a mean age of 36.8 years (range,18-58 years).There were 17 patients with fresh fractures and 1 with old fracture nonunion.Lateral condylar fractures occurred in 8 patients and medial condylar fractures in 10.According to Letenneur' s classification,9 fractures were type Ⅰ,3 type Ⅱ and 6 type Ⅲ.Open reduction and internal fixation was performed,including 13 patients being fixed with 2-3 cannulated screws of 4.5 mm via anterior approach and 5 patients with 2-4 headless compression screws of 2.4,3.0 or 4.0 mm via posterior approach.Results Three patients were misdiagnosed at the first visit with a missed diagnosis rate of 17％ (3/18),but were later confirmed in CT scanning.Fourteen patients were followed up for a mean period of 24 months (range,12-60 months),with bony healing in average 12 weeks (range,8-24 weeks).There were no complications of infections,deep vein thrombus,reduction loss,or implant failure.According to Letenneur' s assessment system,the outcome was excellent or good in 11 patients,fair in 2,and poor in 1.Conclusions Early anatomical open reduction and rigid internal fixation are key to successful treatment.Surgical approaches and types,diameters as well as entry directions of screws should be determined with reference to the fracture type,size of fracture fragment and presence or absence of comminution.
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