The patient had no previous history of patella dislocation and pain around the knee. normal vital signs. Redislocation in 37/75 patients followed for 6-24 years. [56]. Singh AP, Dhammi IK, Vaishya R, et al. Hawkins et al[18] found that the recurrent dislocation rate of patients with primary patellar dislocation is related to congenital femoral trochlear dysplasia, high patellar position and large TT-TG. Zeebregts CJ, Zimmerman KW, ten Duis HJ. After the osteochondral mass was fixed in situ to the lateral condyle of the femur, 2 suture ends of the posterior suture anchor penetrate into the front bone tunnels respectively, and after penetrating from the LFC, they are knotted and fixed with 2 suture ends of medial suture anchor respectively (Fig. Jain A, Agrawal P, Chadha M, et al. The patient had an uneventful postoperative recovery. Subchondral insufficiency fracture of the knee is not thought to be caused by bone death but instead by osteoporosis and insufficiency fractures, with histopathologically proven origins in weakened trabeculae and applied microtraumatic forces 6,13. sharing sensitive information, make sure youre on a federal When patients have tenderness along the medial edge of patella and knee joint effusion, it is necessary to actively improve MRI examination, to rule out osteochondral injury. Int Orthop 2015;39:124550. 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. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. [10] Werner and Miller [11] reported that iatrogenic injury is a cause of Hoffa fracture . Bartonicek J, Rammelt S. History of femoral head fracture and coronal fracture of the femoral condyles. [72]. 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 TT-TG Index: a new knee size adjusted measure method to determine the TT-TG distance. [95]. Bone Joint J 2013;95-B:116571. Orthopedics, 2016, 39: e362e366. Twenty-seven-year nonunion of a. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Shetty GM, Wang JH, Kim SK, et al. [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. Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. [65,67] Moreover, headless compression screws can prevent soft tissue irritation and do not need an additional countersinking procedure. Furthermore, a Hoffa fracture is associated with cruciate ligament injury. [22]. Medicine 2022;101:50(e32104). [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. MRI of osteochondral defects of the lateral, [3]. Arthroscopy. The .gov means its official. [82]. Soni A, Sen RK, Saini UC, et al. 3 Although the examined patients were not professional athletes, some differences between these groups are worth mentioning: in the athletes, the medial rather than the lateral condyle was J Knee Surg. 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. Intra-articular dislocation of the patella with incomplete rotation--two case reports and a review of the literature. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. An appropriate surgical approach allowing full fracture exposure is selected based on fracture type. Egol KA, Broder K, Fisher N, 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. Heuschen UA, Gohring U, Meeder PJ. Emerg Radiol 2015;22:3378. Lateral-view radiograph of the left knee demonstrating an abnormally deep depression of the medial condylopatellar sulcus (arrow). 2021;13(1_suppl):966S73S. doi: 10.1097/MD.0000000000032104. Through the lateral parapatellar approach, we reduced the osteochondral mass and bundled it with absorbable sutures of anchors. Vivek T, Saubhik Da, Sahil G, et al. The bone mass is missing at the fracture. [73] This approach is suitable for the treatment of Hoffa fracture with patella dislocation. Research Article: Systematic Review and Meta-Analysis. [64]. Lateral radiographs of the affected knee were inspected for a . Osteochondral fractures of the lateral. Knee flexion angle is more important than guidewire type in preventing posterior femoral cortex blowout: a cadaveric study. Arthroscopic; Internal fixation; Osteochondral fracture; Suture anchor; TWINFIX Ti. Arthroscopy. An unusual fracture of the lateral femoral condyle in a child. [1,2] However, most LFC cartilage injuries are located in the anterior non-weight-bearing area. Characteristics of Osteochondral Fractures Caused by Patellar Dislocation. Please enable it to take advantage of the complete set of features! In these fractures, the popliteus tendon and the lateral head of the gastrocnemius muscle remain attached to the fragment. government site. [11] The presence of a thick ligament in a relatively small femur is also a risk factor for a Hoffa fracture.[2730]. [53]. [99]. Bauer KL. In the anteroposterior radiograph of the femoral condyle, the trabecular bone structure of the femoral condyles is disordered, with poor continuity of the cortex. Osteochondral fracture (OCF) in weight-bearing area of lateral femoral condyle (LFC) is a rare combined injury caused by patellar dislocation. 2013;33:5118. After 1 year follow-up, good functional and radiographic outcome were obtained. Nonunion of coronal shear fracture of femoral condyle. [7] Nondisplaced Hoffa fractures are difficult to visualize on anterior and lateral radiographs of the knee. Knee 2004;11:1257. -, Patel JM, Saleh KS, Burdick JA, Mauck RL. [24]. Surgically treated Hoffa Fractures with poor long-term functional results. Vaishya R, Singh AP, Dar IT, et al. (B) MRI examination of the right knee joint: a patchy bone signal was seen in the anterior and lower part of the distal femur. J Bone Joint Surg Am 2008;90:46370. Medicine (Baltimore). J Pediatr Orthop. [17]. Some error has occurred while processing your request. J Pediatr Orthop B, 2013, 22: 344349. may email you for journal alerts and information, but is committed [90]. [58]. Active and passive knee flexion exercise of the right knee was gradually strengthened 6 weeks after operation. Soraganvi PC, Narayan Gowda B, Rajagopalakrishnan R, et al. [59]. [18]. 2012;40:191623. Iwai T, Hamada M, Miyama T, et al. Bookshelf 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. 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) 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. Factors of patellar instability: an anatomic radiographic study. Z Orthop Ihre Grenzgeb. 1994;2:1926. Buttress plating for a rare case of comminuted medial condylar. Get new journal Tables of Contents sent right to your email inbox, http://creativecommons.org/licenses/by-nc-nd/4.0, Hoffa fracture of the femoral condyle: Injury mechanism, classification, diagnosis, and treatment, Articles in Google Scholar by Yabin Zhou, MD, Other articles in this journal by Yabin Zhou, MD, Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A meta-analysis of randomized controlled trails, Hoffa fracture combined with rotational dislocation of the knee joint: A novel case report, PET/CT-negative malignant spine tumor with pathologic fracture: A case report of malignant solitary bone plasmacytoma, Prognostic factors to survival of patients with chondroblastic osteosarcoma, Ankle joint dislocation treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis, Privacy Policy (Updated December 15, 2022). Anchor absorbable suture bridge fixation is rigid enough, which can avoid second operation, save cost and good outcome could be expected, which is worth exploring; Of course, a large number of clinical data are needed for further comparative study. 2). The widely known Letenneur classification not only clarifies the relationships between the fracture line and ligaments and soft tissue, but also has significance for clinical treatment and prognosis. [3,4] In 1888, Hoffa described coronal fracture of the femoral condyle but did not indicate the source of the previous reference. to maintaining your privacy and will not share your personal information without Our hospital's institutional review board waived the need for ethical approval for this review paper. computed tomography scan and magnetic resonance (MRI) examination of knee joint further confirmed loose body within the knee joint, osteochondral defect in weight-bearing area of LFC and avulsion of medial patellofemoral ligament (Fig. 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. J Surg Case Rep 2012;2012:10. The distal femur is the area of the leg just above the knee joint. We used the key words Hoffa fracture and coronal fracture of femoral condyle for the knowledge. Zhou, Yabin MDa,b; Pan, Ying MDc; Wang, Qingxian MDa; Hou, Zhiyong MDa; Chen, Wei MDa,, aDepartment of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Orthopedic Research Institution of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, bDepartment of Orthopedic Surgery, Shijiazhuang The Third Hospital. Among the various types of Hoffa fractures, the Letenneur II is unique because the fragments are small and difficult to fix, and poor blood supply to the fragments impairs its healing. Fracture lines are often located where the anterior cruciate ligament and lateral collateral ligaments attach. Radiographs of knee joint show loose body in joint. modify the keyword list to augment your search. Arthroscopy-assisted fracture fixation. The appropriate surgical plan is chosen based on the location of the Hoffa fracture, characteristics of the fracture line, fracture severity, and associated injuries. Hoffa's fractures. Ercin E, Baca E, Kural C. Arthroscopic. [60]. Suture anchor system is mostly used to repair rotator cuff and patellar tendon. Comminuted fractures are a type of broken bone. The white arrow indicate the defect area. Chin J Orthop Trauma 2009;9:8503. 2007 Oct;23(10):1133.e1-4. Osteochondral injury after acute patellar dislocation in children and adolescents. Lian X, Zeng YJ. J Trauma 2000;48:15960. Screw insertion direction differs among operative approaches. Cureus 2016;8:e802. [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. Medial and lateral buttressing may be required if either fracture extends proximally in the same plane. [30]. [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. [79]. 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). [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. Epub 2022 Nov 15. [39,40] Wagih[41] reported that, under general anesthesia, patients with Hoffa fracture have instability at 30 of flexion but not with leg straightened. [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. [93] The biggest challenge in the treatment of Hoffa fractures under arthroscopy due to the patella is dissecting the fragments for reduction[94] and placing screws perpendicularly into the fracture line. Kapoor C, Merh A, Shah M, et al. White EA, Matcuk GR, Schein A, et al. For tibial fractures, the use of bone plates or intramedullary nails is recommended if the condition of the local soft tissue is suitable. Materials and methods: This HIPAA-compliant retrospective study was approved by our Institutional Review Board. J Orthop Trauma 2006;20:2736. [17,18] Magnetic resonance imaging (MRI) should be performed when injury is suspected to the meniscus, cruciate ligament, collateral ligament, or other soft tissues to determine the extent of injury,[32] develop appropriate surgical plans, and accurately assess prognosis. A fracture is a broken bone. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. [89]. Khle J, Angele P, Balcarek P, et al. [5] Viskontas et al[69] reported an extensile medial subvastus approach that allows better exposure of the surgical field and protects the blood supply of the bones comparing with the medial parapatellar approach. [15,16] These forces cause gross displacement of the condyle, which can not only rupture the quadriceps tendon but also perforate the skin, resulting in an open injury. your express consent. Data is temporarily unavailable. Werner BC, Miller MD. (A) The fresh 1.5cm1.5cm fracture surface of the lateral condyle of femur was found under arthroscopy. Search for Similar Articles [81] For patients who require a longer healing time, such as those with a higher body mass index or poor compliance, the simple application of a cannulated screw is insufficient to counter the great shearing force between condyles and the tibial plateau when the knee is in flexion. Acta Orthop Belg 2001;67:1328. Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. Fixation with headless screws can reduce the degree of cartilage injury. J Bone Joint Surg Br 1989;71:11820. 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. [41]. 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. The exposed fracture line is initially fixed with a k-wire and screws are placed perpendicular to the fracture surface. How to cite this article: Wu L, Liu C, Jiang B, He L. Treatment of osteochondral fracture of lateral femoral condyle after patella dislocation with anchor absorbable sutures: A new surgical technique and a case report. Arthroscopy 1996;12:2247. Nonunion of a, [62]. Previous article . Federal government websites often end in .gov or .mil. The site is secure. The work cannot be changed in any way or used commercially without permission from the journal. Wu, Liang MMa; Liu, Chao BMb; Jiang, Bing BMc; He, Lijiang MMd,*, a Department of Orthopedic Surgery, First Peoples Hospital of Linpin District, Hangzhou, Zhejiang, China, b Department of General Surgery, Medicine Faculty of Universitas Prima Indonesia, North Sumatra, Indonesia, c Department of General Surgery, Daocheng Country Peoples Hospital, Sichuan, China. In reviewing left knee radiographs that had previously been interpreted as normal, the physical therapist noted an abnormally deep depression of the medial condylopatellar sulcus, which was concerning for a possible impacted osteochondral fracture. repo mobile homes in hammond, la, www paramountplus com xfinity, semantic elevation examples,
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