06 May 2024
: Case report 
Medial Hoffa Fracture: A Case Report and Literature Review of Approach and Management
Challenging differential diagnosis, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Alaa Akel1ABCDEFG, Mohammed Yahia Sarhan2ABCDEFG, Mohammad Abu-Jeyyab
3ABCDEFG*, Salah Tewfik Daradkeh4ABCDEFG, Suhaib Moseley5ABCDEFG, Mohammad Saeed Dawoud5ABCDEFG
DOI: 10.12659/AJCR.943136
Am J Case Rep 2024; 25:e943136
Table 1. Summary of case series of medial Hoffa fractures.
| Author | Cases | Surgical approach | Fixation method | Outcome |
|---|---|---|---|---|
| Kapoor et al []13 | 1 case (38-year-old) letenneur type (II)c fracture | Direct posterior approach | Two headless Herbert screws in posteroanterior direction and non-parallel to each other | ROM from 0° to 125° and full weight bearing at 8 weeks follow-up |
| Ozan et al []14 | 1 case (22-year-old) malunited Hoffa fracture | Medial parapatellar approach | Two 4.5-mm headless compression screws in anteroposterior direction and one from medial to lateral direction | The functional outcome and knee joint alignment were improved without pain or disability |
| Sasidharan et al []15 | 1 case (35-year-old) malunited Hoffa fracture | Medial parapatellar approach | Two 4-mm partially threaded cannulated screws in anteroposterior direction | ROM from 5° to 110° with full weight bearing at 3 months follow-up and pain when knee flexed beyond 110° |
| AlKhalife et al [1]16 | 1 case (12-year-old) letenneur type (III) fracture | Medial parapatellar approach | 4-mm partially threaded cancellous screws perpendicular to the fracture line | ROM from 15° to 130° without pain (6 months follow-up) |
| Holmes et al []17 | 3 cases | Medial parapatellar approach | AP: multiple parallel 3.5-mm screws | Mean Knee Society score 173 (160–180). Mean follow-up 37 months (18 to 57) |
| Chang et al []18 | 2 cases; both patients had poliomyelitis | Percutaneous (1) and open approach (1) | AP. 2 Acutrak screws | Fracture with displacement seen at 2 weeks. The revision includes the use of a 4.5-mm Dynamic Compression Plate (DCP) with a buttress plate design, along with 3 4.5-mm cortical screws placed proximal to the fracture site.The procedure involves the insertion of 2 Acutrak screws, one having an AP orientation and the other being a 4.5-mm cortical screw with a washer. These screws are placed proximally and laterally from the medial condyle. The range of motion (ROM) for the percutaneous case was from 0° to 100°, with a follow-up period of 9 months. For the revised open case, the ROM was from 0° to 110°, with a follow-up period of 5 months |
| Miyamoto et al []19 | 1 case, with ipsilateral femoral shaft fracture | – | AP. Two 3.5-mm cortical screws | No pain and full ROM at 3-month follow-up |
| Ocguder et al []20 | 1 case, with ipsilateral tibial spine avulsion and PCL rupture | Medial parapatellar approach | AP. 2 Acutrak screws | At 5 months postop ROM 0° to 35°. Modified Judet’s quadricepsplasty Performed. ROM 130° flexion (5-month follow-up) |
| AP – anterioposterior; Lat – lateral; ROM – range of motion; ACL – anterior cruciate ligament; PCL – posterior cruciate ligament. | ||||