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Eur J Trauma Emerg Surg (2010) 36:477479 DOI 10.1007/s00068-010-0014-0
CASE REPORT
Hoffa fracture: xation using headless compression screws
V. Borse J. Hahnel A. Cohen
Received: 28 July 2009 / Accepted: 30 January 2010 / Published online: 27 April 2010 Urban & Vogel 2010
AbstractIntroduction Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane. Case Presentation We report the case of an isolated, low energy, closed, displaced, lateral femoral condyle Hoffa fracture in a 54 year old Caucasian man. This was treated by open reduction and internal xation using two headless compression screws. At 1 year review the patient was pain free, the fracture had radiographically united and there was a range of movement to his knee of 0 100 .
Discussion Traditional methods of xation for Hoffa fractures have led either to the application of complicated constructs attempting to achieve stability, or to large articular surface defects created whilst countersinking headed lag screws. Both have negative implications for the patient. We describe a novel method, not previously described in the literature, using screws in a posterior to anterior direction. This provides compression perpendicular to the fracture site whilst protecting against shear and torsional forces, thereby providing more stable xation. Furthermore, our method allows for a minimally invasive approach and uses headless compression screws, which reduces the chance of damage to the articular surface and is, therefore, less physiologically invasive.
Keywords Hoffa Distal femoral fracture
Headless compression screws AO 33B3
Introduction
Hoffa fractures are uni- or (more rarely) bicondylar fractures of the distal femur in a coronal tangential plane. Traditional methods of xation have resulted in complex constructs to attempt to achieve stability, such as a buttress T-plate or LISS system [1], or in large articular surface defects created whilst countersinking headed lag screws. We report the case of a displaced Hoffa type lateral femoral condyle fracture openly reduced and xed using two headless compression screws. This allowed for a minimally invasive approach with reconstruction using screws in a posterior to anterior direction, providing more stable xation [2]; it also provided compression perpendicular to the fracture site whilst protecting against shear and torsional forces.
Case report
A 54-year-old Caucasian man was crossing a cattle grid and trapped his...