A swashbuckler approach[34,72] can be used to treat bicondylar Hoffa fractures because it protects the Quadriceps femoris abdomen during surgery, allowing quick postoperative recovery of muscle strength and range of motion. 5cm cartilage mass was stripped from nonweight-bearing area of the LFC, and no osteochondral mass was found at the medial edge of patella (Fig. 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]. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. One hundred five relevant articles were reviewed, and the clinical knowledge base was summarized. Based on plate position, screws can be combined with a lateral antigliding plate[84] or a posterior antigliding plate.[55,87]. Careers. Arastu MH, Kokke MC, Duffy PJ, et al. doi: 10.1097/MD.0000000000032104. [99] The patella may become incarcerated in the intercondylar fossa, wedged between the femoral condyles, or even rarely incarcerated in the Hoffa fracture. [9]. During the operation, we found that 2.5*2. Improving the accuracy and timeliness of Hoffa fracture diagnosis and improving minimally invasive treatment outcomes remain the focus of orthopedic surgeons. J Bone Joint Surg Am 2006;88:22704. Acta Orthop Scand 1997;68:4246. Osteochondral fractures of the lateral. 1982;68:31725. McDonough PW, Bernstein RM. Wagih AM. to maintaining your privacy and will not share your personal information without (B) The sutures passing through the bone canal and the corresponding sutures on the anchor were tightened and fixed. Ostermann PA, Neumann K, Ekkernkamp A, et al. Viskontas DG, Nork SE, Barei DP, et al. [55] Onay et al[79] performed a long-term follow-up study of Hoffa fracture patients treated with screws and observed that the screws provided sufficient biomechanical stability until the fractures were healed. Some patellar dislocations are difficult to treat with closed reduction because the patella is attached to the intercondylar fossa by the quadriceps femoris[98] and rotational or vertical displacement is present. Tsai CH, Hsu CJ, Hung CH, et al. J Bone Joint Surg Am 2005;87:5649. 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. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. Arthroscopy-assisted fracture fixation. Agarwal S, Giannoudis PV, Smith RM. (A) One 1.5mm Kirschner wire temporarily fixed the fracture block of the lateral condyle of the femur. A rare case of unicondylar medial, [24]. Open reduction and internal fixation are preferred. After 1 year follow-up, good functional and radiographic outcome were obtained. Hoffa fragment associated with a femoral shaft fracture. Radiography can reveal fracture lines. A case of distal femur medial condyle Hoffa type II(C) fracture treated with headless screws. modify the keyword list to augment your search. Cartilage injury of lateral femoral condyle (LFC) caused by patellar dislocation is very common, with an incidence rate of 31% to 40%. Smith EJ, Crichlow TP, Roberts PH. Tan Y, Li H, Zheng Q, et al. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. Acta Biomater, 2019, 93:222238. Dejour H, Walch G, Nove-Josserand L, et al. Subchondral impaction fractures of the non-weight-bearing - PubMed [18]. [96,97] Thus, closed reduction is recommended when Hoffa fracture is accompanied by patella dislocation. In the anteroposterior radiograph of the femoral condyle, the trabecular bone structure of the femoral condyles is disordered, with poor continuity of the cortex. Distal Femur Fractures - Trauma - Orthobullets Transverse Hoffa's or deep osteochondral fracture? Irreducible, incarcerated vertical dislocation of patella into a. [7]. Fractures of the thighbone that occur just above the knee joint are called distal femur fractures. Gesslein M, Merkl C, Bail HJ, et al. [65]. [12,13] Most researchers[2,7,14] currently believe that when the knee is in 90 of flexion and emergency braking is performed while driving a car, an axial force in either a varus or valgus direction is transferred from the proximal femur to the femoral condyle. 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. The exposed fracture line is initially fixed with a k-wire and screws are placed perpendicular to the fracture surface. Previous article . Shah et al[19] systematically reviewed the recurrent patellar dislocation and found that the complication rate of patellar medial collateral ligament reconstruction was as high as 26.1%. [53]. [8]. Dhillon MS, Mootha AK, Bali K, et al. 2017;84:4417. 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. [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. Arthroscopic; Internal fixation; Osteochondral fracture; Suture anchor; TWINFIX Ti. [79]. to maintaining your privacy and will not share your personal information without [9] The pain due to these combined injuries often exceeds that caused by the Hoffa fracture, which can lead physicians to miss the latter. [92] Moreover, if soft tissue embedded within the fracture line prevents reduction, arthroscopy can distinguish the tissues and the degree of damage to assist restoration. Palmu S, Kallio PE, Donell ST, et al. Please enable scripts and reload this page. Ann Chir 1978;32:2139. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. [93]. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. [50]. classification; diagnosis; Hoffa fracture; injury mechanism; treatment. [17]. Before Fracture lines are often located where the anterior cruciate ligament and lateral collateral ligaments attach. [100]. The white arrow indicate the defect area. Vivek T, Saubhik Da, Sahil G, et al. Meta plate and cannulated screw fixation for, [86]. Summary Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Active and passive knee flexion exercise of the right knee was gradually strengthened 6 weeks after operation. For bicondylar Hoffa fractures, it is necessary to simultaneously expose both condyles[71] to allow proper reduction. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging. Tripathy SK, Aggarwal A, Patel S, et al. [95] Because Hoffa fractures are intra-articular, the success of anatomical reduction and firm internal fixation is closely related to postoperative complications like traumatic arthritis. Effectiveness of a footprint guide to establish an anatomic femoral tunnel in anterior cruciate ligament reconstruction: computed tomography evaluation in a cadaveric model. The anatomical plate for distal medial condyle fracture of femur should be developed as soon as possible. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: Reduce Pain Restore Movement Optimise Recovery What are Femoral Condyle Fractures? Intraoperative, [12]. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. Xray examination of right knee joint: free bone mass can be seen at, (A) MRI examination of the right knee joint: the bone continuity at the, (A) The fresh 1.5 cm 1.5 cm fracture surface of the lateral, (A) One 1.5 mm Kirschner wire temporarily fixed the fracture block of the, (A) Use of anterior cruciate ligament locator to assist drilling at the distal, (A) Through the hollow needle channel of the femoral intercondylar fossa, the folding, Surgical diagrams (A: osteochondral fracture, Surgical diagrams (A: osteochondral fracture of the lateral femoral condyle; B: fixation of, CT examination 6 months after operation: one screw internal fixation, regular external condyle, (A) A blurred fracture line can be seen at the fracture of the, MeSH Onay T, Glabi D, olak , et al. In addition, the lateral antiglide plate can provide stable support, and in combination with autologous bone grafting can promote fracture healing,[38,55,89] which is especially useful for treating old Hoffa fractures. Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. [61]. The .gov means its official. Am J Sports Med. Lateral-view radiograph of the left knee demonstrating an abnormally deep depression of the medial condylopatellar sulcus (arrow). J Bone Joint Surg Am 1974;56:4234. The patient had no previous history of patella dislocation and pain around the knee. Bookshelf Ji G, Wang S, Wang X, et al. 2021. By definition, secondary osteonecrosis of the knee occurs secondary to an insult. Comminuted fractures are a type of broken bone. absorbable internal fixation; dislocation of patella; femoral condyle; osteochondral fracture. Meyer C, Enns P, Alt V, et al. Distal femur fractures most often occur either in older people whose bones . Mashoof AA, Scholl MD, Lahav A, et al. FOIA Li ZX, Song HH, Wang Q, et al. 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. The patient was evaluated by the physical therapist 2 days after his injury. [83]. However, Gavaskar et al[2] argued that no evidence confirms this correlation. Osteochondral injuries of the knee in pediatric patients. 1994;2:1926. A lateral incision plus Gerdy tubercle osteotomy provides full exposure[68] especially in cases of coronal fracture of the lateral condyle. Wolters Kluwer Health [58]. Acta Orthop Traumatol Turc 2014;48:3837. Akan K, Akgun U, Poyanli O, et al. Marzouki A, Zizah S, Benabid M, et al. Knee Surg Sports Traumatol Arthrosc. 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. Liebergall M, Wilber JH, Mosheiff R, et al. Arthroscopic-assisted fixation of. You may search for similar articles that contain these same keywords or you may
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