AI Article Synopsis
- Hoffa fractures are rare coronal fractures of the distal femur that can be misdiagnosed and are typically treated with surgery, focusing on open reduction and internal fixation.
- This study presents two cases of nonunion in a 56-year-old female and a 64-year-old male, both of whom underwent successful surgical intervention using autologous bone grafts and specific fixation devices, resolving their symptoms without complications.
- The findings emphasize the effective use of bone grafts and specific hardware for treating nonunion in Hoffa fractures, along with the necessity of careful follow-up to monitor for any potential complications.
Article Abstract
Background: A coronal fracture of the distal femoral condyle, known as a Hoffa fracture, seldom occurs and is easy to misdiagnose. Surgery treatment, including open anatomic reduction and internal fixation, is the primary method of treatment. However, cases involving nonunion are extremely rare.
Case Presentation: We reported two cases in a 56-year-old female who visited our outpatient clinic with complaints of locking sensation, swelling, and pain, and a 64-year-old male patient who need additional care after having undergone surgery for a distal femur fracture. They presented with nonunion ofa Hoffa fracture (Letenneur type II), and these cases of nonunion were resolved surgically with debridement, two cannulated lag screws, a lateral extra-articular buttress plate, and the liberal use of autologous bone grafts. After surgery, the two patients were allowed to bear partial weight and perform exercises. They were allowed to walk with full weight-bearing after 3 months. No early complications, such as infection and loss of reduction, were noted after the revision surgery. At the one-year follow-up, both patients had excellent function and reported minimal pain, with a Lysholm score of 94.
Conclusions: Our case reports highlight the importance of the liberal use of autologous bone grafts, which allow stable reconstruction of the affected femoral condyle, thereby restoring joint congruence. A lateral extra-articular buttress plate in combination with two cannulated lag screws is recommended for nonunion in Hoffa fracture patients, and they need to be closely followed up to detect complications promptly, especially those related to nonunion.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454222 | PMC |
| http://dx.doi.org/10.1111/os.12748 | DOI Listing |
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