The .gov means its official. Clinical outcomes after absorbable suture fixation of patellar, [26]. A lateral incision plus Gerdy tubercle osteotomy provides full exposure[68] especially in cases of coronal fracture of the lateral condyle. [83]. Moreover, even if the medial patellar retinaculum is strengthened, the patient still has symptoms such as anterior knee pain. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. The natural history. Based on plate position, screws can be combined with a lateral antigliding plate[84] or a posterior antigliding plate.[55,87]. Unfallchirurg 2004;107:1521. [38]. [7] The development of trochlear sulcus of femur was classified as type A according to Dejour et al,[8] and the TT-TG[9] was 15mm. [16]. Transverse Hoffa's or deep osteochondral fracture? Smith EJ, Crichlow TP, Roberts PH. The patient's treatment plan included 6 weeks of weight bearing as tolerated for the left lower extremity while wearing a knee brace that prevented the final 20 of knee extension, and a program of range-of-motion and progressive resistive exercises, with eventual emphasis on sport-specific activities. Kondreddi V, Yalamanchili RK, Ravi Kiran K. Bicondylar Hoffa's fracture with patellar dislocation - a rare case. [76,77] Fixation with 2 or more screws can prevent rotation and rotational displacement. 2). to maintaining your privacy and will not share your personal information without Radiographs of knee joint show loose body in joint. Before A rare case of unicondylar medial, [24]. [80] From a biomechanical point of view, when the load is in the vertical direction, posteroanterior screw placement has a lower risk of shifting than anteroposterior placement. Lal H, Bansal P, Khare R, et al. [105]. Materials and methods: This HIPAA-compliant retrospective study was approved by our Institutional Review Board. Nonunion of a, [62]. [5]. Vivek T, Saubhik Da, Sahil G, et al. For simple fractures of the medial condyle, a medial parapatellar surgical approach is most commonly used. Preliminary X-ray examination showed osteochondral defects of LFC and loose body in knee joint (Fig. A high-energy injury resulting in a Hoffa fracture of the medial condyle is often associated with a tibia fracture,[18] a bicondylar Hoffa fracture,[44,45] a dislocation of the patella,[14] a knee dislocation,[46] intercondylar and supracondylar fractures,[9,47] and pelvic[48,49] and femoral shaft fractures. your express consent. [99] The patella may become incarcerated in the intercondylar fossa, wedged between the femoral condyles, or even rarely incarcerated in the Hoffa fracture. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures. Technique of reduction and fixation of unicondylar medial, [70]. Highlight selected keywords in the article text. Published by Wolters Kluwer Health, Inc. Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature. A case report. [33]. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. Meta plate and cannulated screw fixation for, [86]. Repair of displaced partial articular fracture of the distal femur: the. Federal government websites often end in .gov or .mil. [10]. You may be trying to access this site from a secured browser on the server. Bioactive factors for cartilage repair and regeneration: improving delivery, retention, and activity. [43]. [57]. may email you for journal alerts and information, but is committed An attempt to treat Hoffa fractures under arthroscopy: A case report. government site. We replaced the anchor suture with (ETHICON VICRYL PLUS VCP 359H) suture during the operation, which is an attempt based on the research of Li,[25] in order to avoid the second operation. J Bone Joint Surg Am 2005;87:5649. Received: 27 October 2022 / Received in final form: 8 November 2022 / Accepted: 9 November 2022. Shah JN, Howard JS, Flanigan DC, et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. -, Biau DJ, Schranz PJ. Injury 2005;36:8625. 2018 Oct;21(5):308-310. doi: 10.1016/j.cjtee.2018.08.004. Conjoint bicondylar, [22]. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. Background The goal of this present study was to precisely determine the dimension and location of the impaction fracture on the lateral femoral condyle in patients with an ACL rupture. Chin J Traumatol 2011;14:1436. White EA, Matcuk GR, Schein A, et al. Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. [52] This fact reminds us that a Hoffa fracture evaluation should be a routine part of the lower-limb and pelvis examination with or without injury. After the osteochondral mass was fixed in situ to the lateral condyle of the femur, 2 suture ends of the posterior suture anchor penetrate into the front bone tunnels respectively, and after penetrating from the LFC, they are knotted and fixed with 2 suture ends of medial suture anchor respectively (Fig. Ercin E, Baca E, Kural C. Arthroscopic. modify the keyword list to augment your search. A review of 23 patients. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. Osteochondral fracture (OCF) in weight-bearing area of lateral femoral condyle (LFC) is a rare combined injury caused by patellar dislocation. MRI reexamination at 18 months after operation showed that the osteochondral mass healed well (Figs. 2014;22:238895. . Lateral radiographs of the affected knee were inspected for a . Please enable scripts and reload this page. Reconstruction of the anterior cruciate ligament of the knee joint can lead to iatrogenic Hoffa fracture. Osteochondral fractures of the lateral. Recurrence after patellar dislocation. This approach can also be used to treat comminuted fractures or complex Hoffa fractures.[18]. Open bicondylar, [23]. McCarthy JJ, Parker RD. Reconstructive osteotomy for a malunited medial. A case of distal femur medial condyle Hoffa type II(C) fracture treated with headless screws. Mootha AK, Majety P, Kumar V. Undiagnosed, [11]. Distal femur fractures most often occur either in older people whose bones . Nakagawa S, Arai Y, Inoue H, et al. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging. Accessibility See this image and copyright information in PMC. Please try after some time. [65]. Gesslein M, Merkl C, Bail HJ, et al. [20]. The authors have no funding and conflicts of interest to disclose. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. The CT classification[32] uses the anatomic femoral axis and a line parallel to the posterior cortex of the femoral condyle to divide the femoral condyle into a, b, and c regions. [64] Open reduction and internal fixation is the 1st choice for the treatment of displaced Hoffa fractures, and it is also suitable for the treatment of nondisplaced Hoffa fractures. FIGURE 2. Nondisplaced Hoffa fractures can be treated with cylindrical plaster cast immobilization with the knee in 10 of flexion. Fixation with an anti-glide plate on the lateral condyle and tibial osteotomy with two 4.5-mm screws is ideal. Analysis of functional outcome of Hoffa fractures: a retrospective review of 32 patients. YZ and YP contributed equally to this work. Arthroscopy. -, Enea D, Busilacchi A, Cecconi S, Gigante A. Latediagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report. An impact fracture is a form of failure where a metal separates into fragments due to a stress applied at a temperature below the metal's melting point. Intertrochanteric femoral fractures occur mostly in the elderly, and the average age of onset is 66-76 years. A patella that is stuck between the tibia and femur can be relocated naturally by flexing of the hip joint with the knee in 110 of flexion under local anesthesia. Tsai et al[103] reported that surgical treatment is the 1st choice for Hoffa fracture accompanied by traumatic patella dislocation; if conservative treatment is adopted, the redislocation rate is as high as 40%. [10,38] Local manifestations of a Hoffa fracture include knee swelling, pain, skin color changes (with or without skin defects), limited knee mobility, and a positive floating patella test. Singh R, Singh RB, Mahendra M. Functional outcome of isolated Hoffa fractures treated with cannulated cancellous screw. PMC Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. An official website of the United States government. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Paa L, Vesel R, Koi J, et al. A meta-analysis by Khle et al[6] show that there is no unified treatment for osteochondral fractures (OCF) of knee joint at present, and the overall failure rate is 17%. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). You may search for similar articles that contain these same keywords or you may [30]. doi: 10.1016/j.arthro.2006.11.029. Neglected. Apropos of 128 cases]. Miyamoto R, Fornari E, Tejwani NC. Guo H, Chen Z, Wei Y, Chen B, Sun N, Liu Y, Zeng C. Orthop Surg. Agarwal S, Giannoudis PV, Smith RM. J Pediatr Orthop B, 2013, 22: 344349. Osteochondral defects of LFC are usually caused by lateral patellar dislocation, most of which are located on the medial side of patella. [19] Therefore, lateral condyle fracture is significantly more common than medial condyle fracture. Li et al[25] used absorbable suture to treat OCF caused by patellar dislocation and achieved good medium-term results. Int Orthop 2015;39:124550. Bookshelf Anchor absorbable suture bridge fixation is rigid enough, which can avoid second operation, save cost and good outcome could be expected, which is worth exploring; Of course, a large number of clinical data are needed for further comparative study. After 1 year follow-up, good functional and radiographic outcome were obtained. [77]. During the operation, we found that 2.5*2. Here, we summarized the injury mechanism, diagnosis, classification, and treatment options of Hoffa fractures. Somford et al[65] showed that the repair strength of absorbable screw fixation is weak, knee joint activity produces greater shear stress, and there is a risk of screw breakage; thus, careful selection of the surgical plan is recommended. Musculoskelet Surg 2012;96:4954. [104]. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . Suture anchor system is mostly used to repair rotator cuff and patellar tendon. Diederichs G, Scheffler S. [MRI after patellar dislocation: assessment of risk factors and injury to the joint]. doi: 10.1097/MD.0000000000032104. Injury 2011;42:14958. Please enable it to take advantage of the complete set of features! Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. The patient was evaluated by the physical therapist 2 days after his injury. (LTC, Lateral Tibial Condyle.) AIMER was located at the outlet of the medial bone canal of the lateral condyle of the femur, and the HANDLE was adjusted to a suitable angle (5060). Wu P, WB, Kong LC, et al. [100]. Atesok K, Doral MN, Whipple T, et al. For more information, please refer to our Privacy Policy. 5cm cartilage mass was stripped from nonweight-bearing area of the LFC, and no osteochondral mass was found at the medial edge of patella (Fig. Irreducible, incarcerated vertical dislocation of patella into a. Gavaskar AS, Tummala NC, Krishnamurthy M. Operative management of Hoffa fractures--a prospective review of 18 patients. The goals of treatment include restoration of function and esthetics. normal vital signs. Injury, 2005, 36: 862865. [92] Moreover, if soft tissue embedded within the fracture line prevents reduction, arthroscopy can distinguish the tissues and the degree of damage to assist restoration. The incidence ratio in male and female patients is in the range . Manfredini M, Gildone A, Ferrante R, et al. Lewis SL, Pozo JL, Muirhead-Allwood WF. [12,37] Orthopedic surgeons treating these patients should be vigilant in diagnosing a Hoffa fracture; patients with undiagnosed injuries experience long-term knee pain and limited knee mobility. Knee flexion was limited less than 60 within 8 weeks after operation, partial weight-bearing was allowed at 8 weeks, followed by full weight bearing from 12 weeks after operation. J Orthop Surg 2017;25:17. Tan Y, Li H, Zheng Q, et al. A patient, 15-year-old, female student. Lian X, Zeng YJ. For bicondylar fractures, a median parapatellar incision can be used. Arthroscopy-assisted fracture fixation. Anchor absorbable suture bridge fixation for this kind of OCF is not only effective, but also economical. [101]. Highlight selected keywords in the article text. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures . For Letenneur II and some Letenneur III fractures close to the posterior cortex of the femoral condyle, cannulated lag screw fixation is commonly used. In such cases, the forces necessary for closed reduction can result in cartilage injury or a small avulsion fracture of the patella. Previous article . Hoffa's fractures. In these cases, the associated patellar fracture results from a combination of forces: direct trauma causing the Hoffa fracture and possible indirect injuries from sudden contraction of the quadriceps muscle causing a vertical patellar fracture.[23]. Non-union coronal fracture femoral condyle, sandwich technique: a case report. Med Sci Monit, 2012, 18: CS117CS120. Dave LY, Nyland J, Caborn DN. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. [2]. Two cartilage masses can be seen during the operation. [95]. Internal fixation with headless compression screws and back buttress plate for. [17]. Two patients with osteochondral injury of the weight-bearing portion of the lateral. [7] Nondisplaced Hoffa fractures are difficult to visualize on anterior and lateral radiographs of the knee. Ji G, Wang S, Wang X, et al. Braune C, Rehart S, Kerschbaumer F, Jger A. 1994;2:1926. As the knee is being extended and in full extension, it can be seen that femoral and tibial surfaces do not articulate with each other. Supervision: Qingxian Wang, Zhiyong Hou, Wei Chen. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. [93]. [80]. [102]. A 15-year-old female student accidentally sprained her right knee while participating in sports activities. The appropriate surgical plan is chosen based on the location of the Hoffa fracture, characteristics of the fracture line, fracture severity, and associated injuries. 1986;14:11720. Acta Orthop Scand 1997;68:4246. Khle J, Angele P, Balcarek P, et al. Wolters Kluwer Health Min L, Tu CQ, Wang GL, et al. deep lateral sulcus sign - depression of lateral femoral condyle representing impaction fracture anterior tibial translocation sign Segond fracture arcuate fracture joint effusion CT Considered to have high specificity and sensitivity in detecting anterior cruciate ligament disruption 6. Complained of swelling and pain of the right knee after spraining during sports activities, demonstrated painful limited motion. [51]. If fractures are present they are usually associated with orbital rim or other significant craniofacial injuries. In reviewing left knee radiographs that had previously been interpreted as normal, the physical therapist noted an abnormally deep depression of the medial condylopatellar sulcus, which was concerning for a possible impacted osteochondral fracture. [6]. Pathology. 2004 Jan-Feb;142(1):103-8. doi: 10.1055/s-2004-817655. 2007 Oct;23(10):1133.e1-4.
Johnny Maestro Liver Cancer,
Aventura Hospital Billing Department,
The Troubles In Castlewellan,
Articles I