normal vital signs. Knee Surg Sports Traumatol Arthrosc. Arthroscopic reduction and internal fixation of a displaced intraarticular lateral femoral condyle fracture of the knee. Making the diagnosis of a Hoffa fracture is challenging. Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Singh AP, Dhammi IK, Vaishya R, et al. following anterior cruciate ligament repair) Location The recognized sites of osteochondral defects are: femoral condyle (most common in the lateral aspect of the medial femoral condyle) humeral head talus capitellum of the humerus Staging Refixation of large osteochondral fractures after patella dislocation shows better mid- to long-term outcome compared with debridement. Soft tissues are retracted to . Type II is a fracture horizontal to the base of the posterior condyle with fracture lines located posterior to the attachment point of the lateral collateral ligament. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. The patient was referred to an or- thopaedic surgeon, who recommended conservative management. (A) MRI examination of the right knee joint: the bone continuity at the edge of the lateral condyle of the right femur was poor, the patchy high signal intensity was seen in the bone marrow cavity of the lateral condyle of the femur, and the local cartilage became thinner in the corresponding area. The Letenneur classification, computed tomography (CT) classification, the AO classification, and the AO classification with supplement are widely used in clinics to categorize Hoffa fractures. Bioactive factors for cartilage repair and regeneration: improving delivery, retention, and activity. You may be trying to access this site from a secured browser on the server. Summary Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Arthroscopy 1996;12:2247. 2021 Jan 26;9(1):2325967120974649. doi: 10.1177/2325967120974649. [78]. Radiographic appearance Liebergall M, Wilber JH, Mosheiff R, et al. Calmet J, Mellado JM, Garcia Forcada IL, et al. and transmitted securely. When the patient was sent to the emergency room, the right knee swelled obviously, tenderness over the medial border of the patella, the apprehension test was positive, lateral stress test was negative, and the knee range of motion:F/E 90/0. However, if the tunnel is too close to the distal femoral articular surface and too little cartilage-covered bone is retained, either the passage of the tendon through the bone tunnel or fixation of the tendon can lead to a Hoffa fracture. Oral application of Qiangguyin Keli and alendronate sodium vitamin D3 tablets in postoperative anti-osteoporosis. Osteochondral injury after acute patellar dislocation in children and adolescents. Please enable it to take advantage of the complete set of features! (A) Use of anterior cruciate ligament locator to assist drilling at the distal end of the femur. 1 It has been proved that compression of the posterior border of . Valgus strain on the knee and the continuous pull of the quadriceps causes the patella to ride against the femoral condyle, resulting in rotation around its vertical axis. (A) The fresh 1.5cm1.5cm fracture surface of the lateral condyle of femur was found under arthroscopy. 1). [15,1720] The fracture line its inclination angle of a Hoffa fracture depend on the degree of knee joint flexion at the time of trauma[18]; as the angle of knee flexion increases, the fracture line will occur farther from the posterior cortex of the femoral-condyle. doi: 10.1097/MD.0000000000032104. Technique of reduction and fixation of unicondylar medial, [70]. Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. Callewier et al[23] reported a patient who used absorbable pin fixation to treat OCF in the weight-bearing area of LFC. Moreover, the placement of a posterior antiglide plate with screws strips more soft tissue, especially the insertion of the gastrocnemius heads, and may destroy the blood supply to the fragments. At present, open reduction is often used to treat osteochondral fractures. Acta Orthop Belg 2001;67:1328. Knee Surg Sports Traumatol Arthrosc 2011;19:3209. Injury 1989;20:3714. Ostermann PA, Neumann K, Ekkernkamp A, et al. Epub 2018 Oct 4. Orthop J Sports Med. Introduction. [16]. Acta Biomater, 2019, 93:222238. [3]. Rue JP, Busam ML, Detterline AJ, et al. Distal pulses and sensation were intact. 2013;185:61120. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. Arthroscopy-assisted, [55]. [33]. 1994;2:1926. Chin J Traumatol. Nonunion of a. One hundred five articles on Hoffa fractures were reviewed, and the clinical knowledge base was summarized. Med Sci Monit, 2012, 18: CS117CS120. In these fractures, the popliteus tendon and the lateral head of the gastrocnemius muscle remain attached to the fragment. Apropos of 128 cases]. For example, a fracture line dividing the femoral condyle surface into 2 parts is classified as type I; 2 fracture lines dividing the femoral condyle surface into 3 parts is type II; and 3 or more fracture lines dividing the femoral condyle surface into 4 or more parts is type III. This approach can also be used to treat comminuted fractures or complex Hoffa fractures.[18]. * Correspondence: Lijiang He, Department of Orthopedic Surgery, Second Peoples Hospital of Yuhang District, Hangzhou, Hangzhou, Zhejiang 311121, China (e-mail: [emailprotected]). Objective: To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. For tibial fractures, the use of bone plates or intramedullary nails is recommended if the condition of the local soft tissue is suitable. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. [10] Some of these patients may have a history of poliomyelitis that predisposes individuals to osteoporosis. Radiography can reveal fracture lines. Gavaskar AS, Tummala NC, Krishnamurthy M. Operative management of Hoffa fractures--a prospective review of 18 patients. Your message has been successfully sent to your colleague. Knee 2004;11:1257. Screw pullout strength: a biomechanical comparison of large-fragment and small-fragment fixation in the tibial plateau. Our hospital's institutional review board waived the need for ethical approval for this review paper. 1). PMC [72]. Jain A, Aggarwal P, Pankaj A. Concomitant ipsilateral proximal tibia and femoral Hoffa fractures. Cruciate fracture of the distal femur: the double. [10]. When high-energy trauma involves the distal femur, the lateral condyle is often damaged[18] before the medial condyle because of the physiologic genu valgum of the knee joint. Xray examination of right knee joint: free bone mass can be seen at the anterior edge of the femur in the knee joint. [96]. Search for Similar Articles Soni A, Sen RK, Saini UC, et al. Pa a et al[17] reported that 10 patients with patellar osteochondral mass less than 2.7mm2 caused by patellar dislocation still achieved good function only by taking out the loose body, and no patellar dislocation was found. Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. Life (Basel). Conjoint bicondylar, [22]. Intra-articular dislocation of the patella. [7]. Antigliding plating for Letenneur type I Hoffa fractures. We prospectively documented all potential cases of non-weight-bearing posterior subchondral impaction fractures of the femoral condyles diagnosed on magnetic resonance imaging (MRI) of the knee performed at our institution between January 2006 and December 2011. Highlight selected keywords in the article text. Technique for Treatment of Subchondral Compression Fracture of the Lateral Femoral Condyle Associated With ACL Tear Technique for Treatment of Subchondral Compression Fracture of the Lateral Femoral Condyle Associated With ACL Tear Arthrosc Tech. Acute patellar dislocation in children and adolescents: a randomized clinical trial. According to the internal fixation principle, the antiglide plate should be fixed in the posterior position. Injury, 2005, 36: 862865. The bone contusions on the lateral femoral condyle, lateral aspect of the tibial plateau, medial femoral condyle, and medial aspect of the tibial plateau were documented. [74]. 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). Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report. [99]. [58]. Pure lateral blow-out fractures are rare, as the bone is thick and bounded by muscle. Iwai T, Hamada M, Miyama T, et al. Atesok K, Doral MN, Whipple T, et al. [54] However, popliteal and gastrocnemius muscle traction and foot or ankle movement can lead to fracture redisplacement,[5557] which can cause delayed fracture healing, nonunion, traumatic arthritis, knee dysfunction, and other complications. Letenneur J, Labour PE, Rogez JM, et al. Type 2 fractures require a . Lateral Femoral Condyle (LFC) osteochondral fracture (HSL, Hill-Sachs-like Lesion) can be seen in 30 of knee flexion. Type I, the most common classification, is a vertical fracture line parallel to the posterior cortex of the femur and involves the entire condyle. Arthroscopic. Sagittal MRI images were reexamined 18 months after operation, MRI = magnetic resonance. modify the keyword list to augment your search. However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. 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]. [76]. [10] Werner and Miller [11] reported that iatrogenic injury is a cause of Hoffa fracture . Please try after some time. [11] The presence of a thick ligament in a relatively small femur is also a risk factor for a Hoffa fracture.[2730]. The tears of the lateral meniscus and medial meniscus were detected during arthroscopy. Two days after injury, we performed open reduction and internal fixation using locking compression plate for proximal tibia and screws. 2018;31:38291. Recently, impaction fractures in the non-weight-bearing area of the lateral femoral condyle were reported in 16 of 6600 patients who underwent knee MRI. -, Patel JM, Saleh KS, Burdick JA, Mauck RL. After physical examination, it was found that apprehension test was negative, patellar glide and tilt tests was negative. [42]. Akan K, Akgun U, Poyanli O, et al. [25] Loss of bone matrix results in brittle, weaker bones that break rather than bend with external force. [5]. For more information, please refer to our Privacy Policy. http://creativecommons.org/licenses/by-nc-nd/4.0. MRI of osteochondral defects of the lateral, [3]. Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. This is the first case to apply the suture anchor system to the reduction and fixation of fracture. [1]. In the AO classification, Hoffa fracture is classified as type B3.2. [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. Complications of anterior cruciate ligament reconstruction with bone-patellar tendon-bone constructs: care and prevention. [10]. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures. [6,45,48,5863] Therefore, we must strictly control the indications for conservative treatment. The white arrow indicate the defect area. 1986;14:11720. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. [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. Intertrochanteric femoral fractures occur mostly in the elderly, and the average age of onset is 66-76 years. Jarit GJ, Kummer FJ, Gibber MJ, et al. [66]. Am J Sports Med 2008;36:37994. Tsai CH, Hsu CJ, Hung CH, et al. [14]. Please try again soon. In some cases, the Letenneur II fragment is small but essential for the knee join when flexed at 90 because it ensures the articular surface integrity. Lian and Zeng[85] and Zhao et al[86] treated Hoffa fracture patients with plates combined with screws and achieve good results. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: Reduce Pain Restore Movement Optimise Recovery What are Femoral Condyle Fractures? Get new journal Tables of Contents sent right to your email inbox, December 16, 2022 - Volume 101 - Issue 50, Creative Commons Attribution License 4.0 (CCBY), Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report, Articles in Google Scholar by Liang Wu, MM, Other articles in this journal by Liang Wu, MM, Benign optic nerve gliomas in an adult: A case report, Analysis of the most influential publications on vertebral augmentation for treating osteoporotic vertebral compression fracture: A review, A bibliometric and emerging trend analysis on stress granules from 2011 to 2020: A systematic review and bibliometrics analysis, Inhaled opioids for cancer pain relief: A narrative review, Primary seminoma of prostate in a patient with Klinefelter syndrome: A case report, Privacy Policy (Updated December 15, 2022). 3). Kondreddi V, Yalamanchili RK, Ravi Kiran K. Bicondylar Hoffa's fracture with patellar dislocation - a rare case. Uimonen M, Ponkilainen V, Paloneva J, Mattila VM, Nurmi H, Repo JP. (B) 1.5cm1.5cm free bone was found in the knee joint cavity, and the bone fracture was intact. Primary traumatic patellar dislocation. Li et al[25] used absorbable suture to treat OCF caused by patellar dislocation and achieved good medium-term results. The swashbuckler: a modified anterior approach for fractures of the distal femur. White EA, Matcuk GR, Schein A, et al. In contrast, type II fractures have a high risk of nonhealing or delayed healing because of poor adhesion and poor blood supply. Fixation with an anti-glide plate on the lateral condyle and tibial osteotomy with two 4.5-mm screws is ideal. [53] In addition, partial nondisplaced Hoffa fractures are difficult to diagnose on anteroposterior and lateral views of the knee because the fracture lines often overlaps the side or lateral condyle, which can result in a missed diagnosis in as many as 30% of cases.[9,18]. [82]. A radiographic examination should include anteroposterior, lateral, oblique, and stress views of the knee. Lal H, Bansal P, Khare R, et al. 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. [29]. [17]. [50,51] An open supracondylar- intercondylar distal femoral fracture has a 2.8 times more chance of a Hoffa fracture than a closed distal femoral fracture. [19] Therefore, lateral condyle fracture is significantly more common than medial condyle fracture. Medicine101(50):e32104, December 16, 2022. doi: 10.1016/j.eats.2020.02.016. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. [40]. may email you for journal alerts and information, but is committed cDepartment of Pharmacy, The Third Hospital of Hebei Medical University, Shijiazhuang, China. Operative. Federal government websites often end in .gov or .mil. [104]. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. [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. [47]. Following Letenneur classification of coronal fractures of the femoral condyle in the 1970s and the publication of the second version of the Manual of Internal Fixation, the Hoffa fracture has become more widely recognized by orthopedists. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. The work cannot be changed in any way or used commercially without permission from the journal. Bookshelf Gang et al[20] found that there was no statistically significant difference between surgical treatment and non-surgical treatment in patients with patellar side injury of medial collateral ligament of patella. Familiarity with the characteristics of Hoffa fracture on various imaging modalities and an understanding of the mechanism and likelihood of combined injuries contribute to the timely and accurate diagnosis of Hoffa fracture and avoiding misdiagnosis. An appropriate surgical approach allowing full fracture exposure is selected based on fracture type. 8600 Rockville Pike Osteochondral fracture (OCF) in weight-bearing area of lateral femoral condyle (LFC) is a rare combined injury caused by patellar dislocation. Some error has occurred while processing your request. Arthroscopic-assisted fixation of. Type III is an oblique fracture of the femoral condyle with the fracture line located anterior to the joint capsule, anterior cruciate ligament, lateral collateral ligament, popliteal tendon, and the lateral head of the gastrocnemius muscle. Coronal fractures of the lateral femoral condyle. Osteochondral fracture involving the weight-bearing portion of the lateral femoral condyle is relatively rare injury as it involves hyper flexion of the knee at the time of . [85]. Knee Surg Sports Traumatol Arthrosc. Sun H, He QF, Huang YG, et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2021. [59] For children and individuals with osteoporosis, low-energy trauma can also lead to a Hoffa fracture. Palmu S, Kallio PE, Donell ST, et al. Medicine (Baltimore). Complications of humerus fracture treatment. Please try after some time. Supervision: Qingxian Wang, Zhiyong Hou, Wei Chen. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. Partial weight bearing with crutches is started at 6 to 8 postoperative weeks. The bone mass is missing at the fracture. Miyamoto R, Fornari E, Tejwani NC. Ul Haq R, Modi P, Dhammi I, et al. J Orthop Trauma 1999;13:13840. gareth ainsworth wife donna, ymca motionvibe login,
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