Hoffa's fracture
Keywords:
Fractura del extremo distal del fémur, Fractura de Hoffa, Reducción asistida por artroscopia, Tomografía computarizadaAbstract
Introduction: Fractures of the distal end of the femur are disabling injuries, among them the Hoffa's fracture is an infrequent condition difficult to diagnose and treat.
Objective: to update on the most important elements of this traumatic entity.
Methods: The search and analysis of the information was carried out over a period of 60 days (November 1 to December 30, 2020) and the following words were used: Hoffa's fracture, AND distal femur fracture, based on the information obtained, a bibliographic review of a total of 529 articles published in the PubMed, Hinari, SciELO and Medline databases using the search manager and reference manager EndNote, 37 selected citations were used to perform the review, 35 of the last five years.
Results: The mechanism of high and low energy production was mentioned. Reference was made to classifications based on plain radiography and computed tomography. The main entities associated with the Hoffa's fracture were exposed. In relation to treatment, conservative and surgical modalities were mentioned, in the latter, the approach routes according to the location and type of fracture, with special emphasis on arthroscopic surgery.
Conclusions: Hoffa fracture is an infrequent injury caused by a high energy production mechanism and occasionally associated with other traumatic entities. The treatment of this condition is generally surgical; the modality to be used is based on the geometric configuration of the fracture.
DeCS: FEMORAL FRACTURES/classification; FEMUR/injuries; ARTHROSCOPY/methods; TOMOGRAPHY, X-RAY COMPUTED; REVIEW LITERATURE AS TOPIC.
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References
1. Collinge CA, Wiss DA. Distal femur fractures. En: Tornetta P, Ricci WM, Court Brown CM, McQueen MM, Heckman JD, editors. Rockwood and Green's Fractures in Adults. 8th ed. Philadelphia: Wolters Kluwer Health;2015.p.2229-66.
2. Egol KA, Broder K, Fisher N, Konda SR. Repair of displaced partial articular fracture of the distal femur: the Hoffa fracture. J Orthop Trauma [Internet]. 2017 Ago [citado 07 Ene 2021];31(Suppl 3):S10-S11. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28697072/.
3. Patel PB, Tejwani NC. The Hoffa fracture: Coronal fracture of the femoral condyle a
review of literature. J Orthop [Internet]. 2018 Jun [citado 07 Ene 2021];15(2):726-731. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990301/.
4. Jordan MC, Bittrich LA, Fehske K, Meffert RH, Jansen H. A rare case of Hoffa fracture combined with lateral patellar dislocation. Trauma Case Reports [Internet]. 2017 [citado 07 Ene 2021];9:13-16. Disponible en: https://d-nb.info/1155098226/34
5. Kapoor C, Merh A, Shah M, Golwala P. A Case of Distal Femur Medial Condyle Hoffa Type II(C) Fracture Treated with Headless Screws. Cureus [Internet]. 2016 Sep [citado 07 Ene 2021];8(9):e802. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081261/
6. Trikha V, Das S, Gaba S, Agrawal P. Analysis of functional outcome of Hoffa fractures: a
retrospective review of 32 patients. J Orthop Surg [Internet]. 2017 Jul [citado 07 Ene 2021];25(2):1-7. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/2309499017718928
7. Chandrabose R, Saha S, Kumar H, Tapadiya N, Hd B. A computed tomography-based classification of Hoffa fracture: surgical treatment considerations and prognostic outcome with assessment of reproducibility. J Orthop [Internet]. 2019 Dic [citado 07 Ene 2021];20:21-27. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32021051/
8. Xie X, Zhan Y, Dong M, He Q, Lucas JF, Zhang Y, et al. Two and three-dimensional CT mapping of Hoffa fractures. J Bone Joint Surg Am [Internet]. 2017 Nov [citado 07 Ene 2021];99(21):1866-1874. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29088042/.
9. Pires RE, Giordano V, Fogagnolo F, Yoon RS, Liporace FA, Kfuri M. Algorithmic treatment of Busch-Hoffa distal femur fractures: a technical note based on a modified Letenneur classification. Injury [Internet]. 2018 Ago [citado 07 Ene 2021];49(8):1623-1629. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29885965/
10. Hill BW, Cannada LK. Hoffa fragments in the geriatric distal femur fracture: myth
or reality? Geriatr Orthop Surg Rehabil [Internet]. 2017 Dic [citado 07 Ene 2021];8(4):252-255. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755847/.
11. Joseph CM, Rama-Prasad YS, Boopalan PRJVC, Jepegnanam TS. Long term follow-up of an open bicondylar Hoffa fracture with a disrupted extensor mechanism: a case report. Malays Orthop J [Internet]. 2019 Jul [citado 07 Ene 2021];13(2):59-62. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702977/.
12. Harna B, Dwivedi DD, Pippal HK, Sabat D. Bicondylar conjoint Hoffa's fracture with patella entrapped in the fracture: a rare case report. J Clin Orthop Trauma [Internet]. 2018 Jun [citado 07 Ene 2021];9(Suppl 2):S35-S38. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008609/.
13. Kumar P, Agarwal S, Kumar D, Rajnish RK, Jindal K. Rim plating for a rare variant of posteromedial tibial condyle fracture; partial coronal split, akin to Hoffa's fracture, associated with multi-ligament injuries and central depression. Trauma Case Rep [Internet]. 2019 [citado 07 Ene 2021];20. Disponible en: https://doaj.org/article/51646e92291246a5a7927d8d58a9a713
14. Coo MS, Best BJ. Distal femur fractures [Internet]. 2021 Ago [citado 07 Ene 2021]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK551675/.
15. Yao SH, Su WR, Hsu KL, Chen Y, Hong CK, Kuan FC. A biomechanical comparison of two screw fixation methods in a Letenneur type I Hoffa fracture. BMC Musculoskelet Disord [Internet]. 2020 Jul [citado 07 Ene 2021];21:497. Disponible en: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03527-4
16. Zhou Y, Pan Y, Wang Q, Hou Z, Chen W. Hoffa fracture of the femoral condyle: Injury mechanism, classification, diagnosis, and treatment. Medicine [Internet]. 2019 Feb [citado 07 Ene 2021];98(8):14633. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30813201/.
17. Bagaria V, Sharma G, Waghchoure C, Chandak RM, Nemade A, Tadepelli K, et al. A proposed radiological classification system of Hoffa's fracture based on fracture configuration and consequent optimal treatment strategy along with the review of literature. SICOT J [Internet]. 2019 [citado 07 Ene 2021];5:18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557153/.
18. Somford MP, Nieuwe Weme RA, Hoornenborg D, Wiegerinck JI, van Raay JJAM, Brouwer RW, et al. Biographical background and origin of common eponymous terms in orthopedic surgery: anatomy and fractures in knee surgery. Eur J Orthop Surg Traumatol [Internet]. 2018 Ene [citado 07 Ene 2021];28:79-84. Disponible en: https://link.springer.com/article/10.1007/s00590-017-2005-x
19. Gammon L, Hansen E, Cheatham S. Technique for reduction and fixation of a Hoffa fracture with ipsilateral patella dislocation from low-energy trauma, a rare injury: a case report. JBJS Case Connect [Internet]. 2020 Ene-Mar [citado 07 Ene 2021];10(1):e0250. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32224673/
20. Liu Q, Wang W, Fan W, Zhu W. Hoffa fracture associated with tibial shaft fracture and
multiple ligament avulsion fractures: a case report. Trauma Case Rep [Internet]. 2020 Ene [citado 07 Ene 2021];26:100277.Disponible en: https://pubmed.ncbi.nlm.nih.gov/31989015/.
21. Pathak S, Salunke A, Karn S, Ratna HVK, Thivari PS, Sharma S, et al. Hoffa's fracture wih associated injuries around the knee joint: an approach to a rare injury. Cureus [Internet]. 2020 Abr [citado 07 Ene 2021];12(4):e7865. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255537/.
22. Goos JAC, Emmink BL, Nieuwenhuis D, Bosman WM. Hoffa fracture accompanied by dissection of the popliteal artery. BMJ Case Rep [Internet]. 2019 Dic [citado 07 Ene 2021];12(12):e232348. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31818893/.
23. Giotikas D, Nabergoj M, Krkovic M. Surgical management of complex intra-articular distal femoral and bicondylar Hoffa fracture. Ann R Coll Surg Engl [Internet]. 2016 Nov [citado 07 Ene 2021];98(8):e168-e170. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392877/.
24. Xu Y, Li H, Yang HH, Pan ZJ. A comparison of the clinical effect of two fixation methods on Hoffa fractures. Springerplus [Internet]. 2016 Jul [citado 07 Ene 2021];5(1):1164. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27512623/.
25. Xu Y, Li H, Yang HH. [Intercondylar fossa screw with plate fixation for Letenneur type III Hoffa fractures]. Zhongguo Gu Shang [Internet]. 2016 Dic [citado 07 Ene 2021];29(12):1146-1149. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29292892/.
26. Singh R, Singh RB, Mahendra M. Functional outcome of isolated Hoffa fractures treated with cannulated cancellous screw. Malays Orthop J [Internet]. 2017 Jul [citado 07 Ene 2021];11(2):20-24. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630046/.
27. Lian X, Zeng YJ. Meta plate and cannulated screw fixation for treatment of type Letenneur III lateral Hoffa fracture through posterolateral approach. Zhongguo Gu Shang [Internet]. 2018 Mar [citado 07 Ene 2021];31(3):267-271. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29600680/.
28. Zhao LL, Tong PJ, Xiao LW. Internal fixation with lag screws plus an anti-sliding plate
for the treatment of Hoffa fracture of the lateral femoral condyle. Zhongguo Gu Shang [Internet]. 2016 Mar [citado 07 Ene 2021];29(3):266-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27149799/.
29. Lu B, Zhao S, Luo Z, Lin Z, Zhu Y. Compression screws and buttress plate versus compression screws only for Hoffa fracture in Chinese patients: a comparative study. J Int Med Res [Internet]. 2019 Ene [citado 07 Ene 2021];47(1):142-151. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384458/.
30. Onay T, Gülabi D, Çolak İ, Bulut G, Gümüştaş SA, Çeçen GS. Surgically treated Hoffa Fractures with poor long-term functional results. Injury [Internet]. 2018 Feb [citado 07 Ene 2021];49(2):398-403. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29198374/.
31. Orapiriyakul W, Apivatthakakul T, Buranaphatthana T. How to determine the surgical approach in Hoffa fractures? Injury [Internet]. 2018 Dic [citado 07 Ene 2021];49(12):2302-2311. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30526925/.
32. Maheshwari V, Sharma SL, Goyal D, Qureshi P, Hussain Z. Clinical experience with management of Hoffa fractures using headless compression screw and headed screw. J Clin Orthop Trauma [Internet]. 2019 Sep-Oct [citado 07 Ene 2021];10(5):934-940. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739431/.
33. Sun H, He QF, Huang YG, Pan JF, Luo CF, Chai YM. Plate fixation for Letenneur type I Hoffa fracture: a biomechanical study. Injury [Internet]. 2017 Jul [citado 07 Ene 2021];48(7):1492-1498. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28390685/.
34. Tham WW, Khor YP, Chee YH. Deformity correction using the "Sandwich" technique for a non-union Hoffa fracture. Ann Acad Med Singapore [Internet]. 2019 Feb [citado 07 Ene 2021];48(2):63-66. Disponible en: https://annals.edu.sg/pdf/48VolNo2Feb2019/V48N2p63.pdf
35. Ercin E, Baca E, Kural C. Arthroscopic treatment of isolated Hoffa fractures. J Knee Surg [Internet]. 2017 Oct [citado 07 Ene 2021];30(8):842-848. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28219089/.
36. Goel A, Sabat D, Agrawal P. Arthroscopic-assisted fixation of Hoffa fracture: a case report and description of technique. J Clin Orthop Trauma [Internet]. 2016 Ene-Mar [citado 07 Ene 2021];7(1):61-65. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735559/.
37. Xiao K, Chen C, Yang J, Yang D, Liu J. An attempt to treat Hoffa fractures under arthroscopy: a case report. Chin J Traumatol [Internet]. 2018 Oct [citado 07 Ene 2021];21(5):308-310. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30340980/.

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