The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request. In these cases, avulsion of the anterior cruciate ligament along with a large chunk of bone at its insertion[17] can lead to a Hoffa fracture. Papadopoulos AX, Panagopoulos A, Karageorgos A, et al. During the operation, 2 4.5mm anchor (Smith @ nephew TIWNFIX Ultra PK Suture Anchor) was inserted into the posterior edge and medial edge of the cartilage mass in the weight-bearing area, and then 2 non-absorbable sutures on each anchor were replaced by an absorbable suture (ETHICON VICRYL PLUS VCP359H), and finally the 2 ends of the absorbable suture were knotted to prevent sliding. Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. For Letenneur II and some Letenneur III fractures close to the posterior cortex of the femoral condyle, cannulated lag screw fixation is commonly used. The term comminuted fracture refers to a bone that is broken in at least two places. Arthroscopy 2011;27:81724. [75]. 8600 Rockville Pike Ozturk A, Ozkan Y, Ozdemir RM. During complete anterior cruciate ligament (ACL) tears in pivoting mechanisms, the area of the lateral femoral condyle (LFC) localized just above the anterior third of the lateral meniscus (LM) impacts the posterior border of the lateral tibial plateau (LTP), which may result in a subchondral compression fracture. In the type I, an isolated fracture is confined to the coronal plane of 1 condyle (medial or lateral). Paa L, Vesel R, Koi J, et al. Busam ML, Provencher MT, Bach BR. [65,67] Moreover, headless compression screws can prevent soft tissue irritation and do not need an additional countersinking procedure. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. [12,37] Orthopedic surgeons treating these patients should be vigilant in diagnosing a Hoffa fracture; patients with undiagnosed injuries experience long-term knee pain and limited knee mobility. What is an Impact Fracture? - Definition from Corrosionpedia [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. [5]. Transverse Hoffas or deep. Somford MP, van Ooij B, Schafroth MU, et al. Int Orthop. Operative. Depression Of more than 5 mm in a type 3 fracture can treated by elevation from below and (d' supported by bone grafts and fixation. [17]. Starr AJ, Jones AL, Reinert CM. A mechanical evaluation of two fixation methods using cancellous screws for coronal fractures of the lateral condyle of the distal femur (OTA type 33B). The patient's treatment plan included 6 weeks of weight bearing as tolerated for the left lower extremity while wearing a knee brace that prevented the final 20 of knee extension, and a program of range-of-motion and progressive resistive exercises, with eventual emphasis on sport-specific activities. Unfallchirurg 2004;107:1521. Materials and methods: This HIPAA-compliant retrospective study was approved by our Institutional Review Board. [6,45,48,5863] Therefore, we must strictly control the indications for conservative treatment. A patient, 15-year-old, female student. After arthroscopic confirmation of Lateral Femoral Condyle (LFC) ostechondral fracture (HSL, Hill-Sachs-like Lesion) the anterolateral portal is enlarged to 2-3 cm. Vivek T, Saubhik Da, Sahil G, et al. Search for Similar Articles The patient had an uneventful postoperative recovery. Frangakis EK. Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence. According to the internal fixation principle, the antiglide plate should be fixed in the posterior position. Two or 3 cancellous screws (4 or 6.5 mm) can be used to fix the fracture in an anterior-to-posterior direction. Intertrochanteric femoral fractures account for 3.13% of total adult fractures, 24.56% of femoral fractures, and 50% of proximal femoral fractures (Koval et al. Wagih AM. 2013;33:5118. Caton J, Deschamps G, Chambat P, et al. Dejour H, Walch G, Nove-Josserand L, et al. [9]. [Treatment of extensive chondral defects of the patella after patellar dislocation]. Osteochondral injury after acute patellar dislocation in children and adolescents. We do not do patellar medial collateral ligament repair to reduce complications such as knee joint adhesion. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. Arthroscopic; Internal fixation; Osteochondral fracture; Suture anchor; TWINFIX Ti. PDF ssslideshare.com Please enable it to take advantage of the complete set of features! However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. Please enable scripts and reload this page. Impact fractures can be classified either as ductile or brittle depending on the elongation pattern that is present. Epub 2022 Nov 15. J Surg Case Rep 2012;2012:10. normal vital signs. (A) A blurred fracture line can be seen at the fracture of the lateral condyle of the femur. Effectiveness of a footprint guide to establish an anatomic femoral tunnel in anterior cruciate ligament reconstruction: computed tomography evaluation in a cadaveric model. [4]. [18]. 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. Fracture surgery complications include: Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage. [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. -. [97]. [60]. [20]. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. Injury 1989;20:3714. Medline, Embase, the Cochrane Library, Google Scholar, the China National Knowledge Infrastructure, and the China Biology Medicine disc were searched for relevant articles. Acta Orthop Belg 2001;67:1328. Egol KA, Broder K, Fisher N, et al. J Bone Joint Surg Am 2006;88:22704. Reconstruction of Large Osteochondral Lesions in the Knee: Focus on Fixation Techniques. 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. This patient has no patella alta, well developed femoral trochlea, no obvious increase of TT-TG and no previous patellar instability. After physical examination, it was found that apprehension test was negative, patellar glide and tilt tests was negative. [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. In these cases, magnetic resonance imaging (MRI) can show a lateral femoral notch sign: a depression in the lateral femoral condyle, which could indicate an ACL tear .
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