title: Surgical treatment and rehabilitation of medial Hoffa fracture fixed by locking plate and additional screws: A retrospective cohort study.
abstract: OBJECTIVE
  Hoffa fracture fixed by only using a single plate or lag screws might be not strong enough to achieve direct stability. The goal of this study is to determine the functional outcome of the surgical treatment and rehabilitation of medial Hoffa fracture by a locking plate combined with cannulated or lag screws.
  
  
  METHODS
  A total of 13 patients suffering isolated medical Hoffa fractures were identified during the study period (2005.February-2013.February) and retrospectively analyzed. All the fractures were treated by open reduction via the medial approach, and internal fixation by a locking plate combined with cannulated or lag screws. Early active rehabilitation including tele-rehabilitation for rural patients with restricted weight bearing was instituted after the surgical treatment. The radiological and functional outcome analysis was performed by using Knee Society Score (KSS), the range of movement (ROM), and the stability of fixation of the patients during 24 month follow-up.
  
  
  RESULTS
  The bone union of medial Hoffa fractures was achieved in all patients. The articular surface of medial femoral condyle was anatomically reduced. There was no loss of reduction and fixation. All patients achieved satisfactory knee joint function and regained their walking ability with good clinical results through early postsurgical rehabilitation. Ten patients (77%) had 0°-130° range of motion with full extension; two patients (15%) had 0°-115° range of motion; one patient (8%) had 0°-110° range of motion. The KSS of all the patients were more than 80, and the scores of seven patients (54%) were more than 85.
  
  
  CONCLUSIONS
  Fixation with a locking plate and cannulated or lag screws for medial Hoffa fracture seemed to be effective and reliable for achieving anatomical reduction, and gave satisfactory functional results when coupled with aggressive rehabilitation.
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, China.
authors.forename: Mingjie
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, China. Electronic address: taojie123@sjtu.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Tao
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, China.
authors.forename: Zihui
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, China.
authors.forename: Qingbin
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Du
authors.affiliation: The First Clinical Medical College, Nanjing Medical University, 140, Hanzhong Road, Nanjing, Jiangsu 210029, China.
authors.forename: Jieming
authors.initials: J
authors.lastname: Shi
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies
keywords: Locking plate; Medial Hoffa; Rehabilitation; Screw