title: Hoffa fracture: fixation using headless compression screws.
abstract: BACKGROUND
  Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane.
  
  
  METHODS
  We report the case of an isolated, low energy, closed, displaced, lateral femoral condyle Hoffa fracture in a 54 year old Caucasian man. This was treated by open reduction and internal fixation using two headless compression screws. At 1 year review the patient was pain free, the fracture had radiographically united and there was a range of movement to his knee of 0°-100°.
  
  
  CONCLUSIONS
  Traditional methods of fixation for Hoffa fractures have led either to the application of complicated constructs attempting to achieve stability, or to large articular surface defects created whilst countersinking headed lag screws. Both have negative implications for the patient. We describe a novel method, not previously described in the literature, using screws in a posterior to anterior direction. This provides compression perpendicular to the fracture site whilst protecting against shear and torsional forces, thereby providing more stable fixation. Furthermore, our method allows for a minimally invasive approach and uses headless compression screws, which reduces the chance of damage to the articular surface and is, therefore, less physiologically invasive.
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK. v.h.borse@leeds.ac.uk.
authors.forename: V
authors.initials: V
authors.lastname: Borse
authors.affiliation: Department of Orthopaedics, Pinderfields General Hospital, Aberford road, Wakefield, WF1 4DQ, UK.
authors.forename: J
authors.initials: J
authors.lastname: Hahnel
authors.affiliation: Department of Orthopaedics, Pinderfields General Hospital, Aberford road, Wakefield, WF1 4DQ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Cohen
keywords: AO 33B3; Distal femoral fracture; Headless compression screws; Hoffa
references.citation: J Orthop Trauma. 2002 Mar;16(3):172-7
references.pmid: 11880780
references.citation: J Bone Joint Surg Br. 1989 Jan;71(1):118-20
references.pmid: 2914979
references.citation: J Orthop Trauma. 2006 Apr;20(4):273-6
references.pmid: 16721243
references.citation: J Orthop Trauma. 2002 Mar;16(3):178-81
references.pmid: 11880781
references.citation: Injury. 2004 Aug;35(8):828-30
references.pmid: 15246811
references.citation: Ann Chir. 1978 Mar-Apr;32(3-4):213-9
references.pmid: 697301
references.citation: Aktuelle Traumatol. 1994 May;24(3):83-6
references.pmid: 8048369
references.citation: AJR Am J Roentgenol. 2002 Apr;178(4):994
references.pmid: 11906889