title: Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management.
abstract: Coronal plane fractures of the posterior femoral condyle, also known as Hoffa fractures, are rare. Lateral fractures are three times more common than medial fractures, although the reason for this is not clear. The exact mechanism of injury is likely to be a vertical shear force on the posterior femoral condyle with varying degrees of knee flexion. These fractures are commonly associated with high-energy trauma and are a diagnostic and surgical challenge. Hoffa fractures are often associated with inter- or supracondylar distal femoral fractures and CT scans are useful in delineating the coronal shear component, which can easily be missed. There are few recommendations in the literature regarding the surgical approach and methods of fixation that may be used for this injury. Non-operative treatment has been associated with poor outcomes. The goals of treatment are anatomical reduction of the articular surface with rigid, stable fixation to allow early mobilisation in order to restore function. A surgical approach that allows access to the posterior aspect of the femoral condyle is described and the use of postero-anterior lag screws with or without an additional buttress plate for fixation of these difficult fractures.
authors.affiliation: Orthopaedic Surgeon, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. marastu@hotmail.com
authors.forename: M H
authors.initials: MH
authors.lastname: Arastu
authors.forename: M C
authors.initials: MC
authors.lastname: Kokke
authors.forename: P J
authors.initials: PJ
authors.lastname: Duffy
authors.forename: R E C
authors.initials: RE
authors.lastname: Korley
authors.forename: R E
authors.initials: RE
authors.lastname: Buckley
mesh_terms: D001182:Arthroscopy / Q000379:methods; D001863:Bone Screws; D005264:Femoral Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D057072:Intra-Articular Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D016896:Treatment Outcome
keywords: Coronal plane distal femoral fracture; Femur; Hoffa fracture; Surgical treatment; Trauma