Abstract
Fractures of the distal femur typically occur in the axial and sagittal planes. A Hoffa fracture is a coronal plane fracture of the femoral condyle, which accounts for 8.7% to 13% of distal femoral fractures. It is usually associated with other injuries around the knee joint and hence is often missed. We conducted a comprehensive systematic review of papers published in the English language using PubMed, Web of Science, Scopus, and the Cochrane Database, which reported Hoffa's fracture associated with other injuries around the knee joint. We selected 11 eligible papers for final analysis and review. These papers had 12 patients with Hoffa’s fracture, with associated injuries around the knee joint. The associated injuries with Hoffa’s fracture were in the ipsilateral distal femur, proximal tibia fractures, patellar dislocation, patella fracture, and patellar tendon incarceration. The management principles for Hoffa's fracture with associated injuries around the knee joint are: having a high clinical index of suspicion for these injuries, obtaining all trauma series radiographs and computed tomography of the knee, achieving complete articular incongruity, and restoring the functions of the knee joint.
Highlights
Hoffa’s fracture is a coronal-oriented fracture of the distal femur with the fracture line extending through the medial condyle, lateral condyle, or bicondylar region [1,2,3]
Magnetic resonance imaging (MRI) and Computed tomography (CT) of the knee joint plays a vital role in assessing the articular surface congruity of the distal femur and proximal tibia
Literature search results for Hoffa’s fracture and associated injuries around the knee joint were done with the keyword "Hoffa fracture." Search terms were broad to encompass all possibilities for applicable studies
Summary
Hoffa’s fracture is a coronal-oriented fracture of the distal femur with the fracture line extending through the medial condyle, lateral condyle, or bicondylar region [1,2,3]. This fracture presents commonly as an isolated fracture and, in rare instances, it is associated with other injuries around the knee joint. The presence of Hoffa’s fracture warrants proper clinical evaluation and treatment planning for the patient, as these fractures are associated with high-velocity injuries. These injuries usually affect the younger population after a road traffic accident. We have conducted a systematic review of Hoffa’s fracture with associated injures around the joint and have suggested a proper clinical approach for the treatment of these injuries
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