title: Posterior buttress plate with locking compression plate for Hoffa fracture.
abstract: BACKGROUND
  Many difficulties are associated with treating fractures of the posterior condyle of the femur (Hoffa fractures). Anatomical reduction and internal fixation are optimum for such intra-articular fractures. Some surgeons use anteroposterior screws to achieve direct stability. However, screw fixation is not adequate in some cases. To increase stability, we treat Hoffa fractures with a posterior buttress plate; we use a twisted, 1/3 tubular plate at the posterior surface and a supplementary, locking compression plate (LCP) for additional stability.
  
  
  METHODS
  Patients who had sustained Hoffa fractures between January 2006 and March 2009 were included in this study. Patients comprised three males and two females with a mean age of 73.6 years at the time of surgery. A 3.5-mm 1/3 tubular plate was twisted and applied to the posterolateral aspect of the distal femur. This was combined with an LCP on the distal femur to achieve a rafting effect.
  
  
  RESULTS
  All fractures were healed within 15 weeks. There were no instances of nonunion, infection, or implant removal. The mean range of motion was -3° to 121°. Four patients had no pain in the treated limb and one had mild pain on weight bearing. The average Oxford Knee Score was 44.6 points. All patients achieved satisfactory joint function and regained their walking ability with good clinical results.
  
  
  CONCLUSIONS
  Improved stability associated with this technique enables patients to begin range-of-motion training and return to their normal activities sooner; this resulted in good outcome.
authors.affiliation: Department of Orthopaedic Surgery, Okayama Medical Center, 1711-1 Tamasu, Kitaku, Okayama, 701-1192, Japan, tomonori_t31@yahoo.co.jp.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tetsunaga
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
authors.forename: Naofumi
authors.initials: N
authors.lastname: Shiota
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tetsunaga
authors.forename: Arubi
authors.initials: A
authors.lastname: Teramoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000368:Aged; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation; D016059:Range of Motion, Articular