Arthroscopy-assisted treatment of Hoffa fracture associated with ipsilateral femoral shaft, tibial eminence and Malgaigne fractures

Year 2014, Volume: 48 Issue: 5, 602 - 606, 12.11.2014

Kaya Akan Umut Akgun Oguz Poyanli Koray Unay

https://doi.org/10.3944/AOTT.2014.2786

Abstract

Hoffa fracture associated with ipsilateral femoral shaft fractures is a rare clinical entity. We present a previously unreported multi-trauma case with a unique fracture combination of ipsilateral Hoffa, tibial eminence, femoral shaft and Malgaigne fractures. The Malgaigne fracture was treated non-operatively while the other three fractures were operated with arthroscopic and assisted techniques. Despite the use of minimally invasive techniques, the patient experienced postoperative soft tissue problems. In follow-up, all fractures healed with a good functional outcome. The application of a minimally invasive technique in such a high-energy trauma is crucial for prevention of soft tissue complications.

Keywords

Eminence fracture, femoral fracture, hoffa fracture, malgaigne fracture, retrograde femoral nail

İpsilateral femoral şaft, tibial eminens ve Malgaigne kırıklarına eşlik eden Hoffa kırığının artroskopi destekli tedavisi

Abstract

 

Hoffa kırıklarının femur şaft kırıkları ile birlikte izlenmesi nadir bir klinik tablodur. Bu sunumda, aynı tarafta Hoffa, tibial eminens, femoral şaft ve Malgaigne kırıklarının birlikte izlendiği, literatürde bildirilmemiş nadir bir çoklu travma olgusu sunulmaktadır. Konservatif olarak tedavi edilen Malgaigne kırığı dışında kalan üç farklı kırık artroskopi destekli teknikler kullanılarak tedavi edilmiştir. Minimal invaziv tekniklerin kullanılmasına karşın, olguda yumuşak doku problemleri ile karşılaşılmış, takiplerde tüm kırıklar iyi fonksiyonel sonuçlar ile iyileşmiştir. Yüksek enerjili benzer travma olgularında minimal invaziv tekniklerin uygulanması yumuşak doku komplikasyonlarının engellenmesi açısından büyük önem taşımaktadır.

Keywords

Eminens kırığı; femur kırığı; hoffa kırığı; malgaigne kırığı; retrograd femoral çivi.

References

• Kumar R, Malhotra R. The Hoffa fracture: Three case re- ports. J Orthop Surg (Hong Kong) 2001;9:47-51.
• Nork SE, Segina DN, Aflatoon K, Barei DP, Henley MB, Holt S, et al. The association between supracondylar- intercondylar distal femoral fractures and coronal plane fractures. J Bone Joint Surg Am 2005;87:564-9. CrossRef
• Miyamoto R, Fornari E, Tejwani NC. Hoffa fragment associated with a femoral shaft fracture. A case report. J Bone Joint Surg Am 2006;88:2270-4. CrossRef
• Demirel M, Dereboy F, Ozturk A, Turhan E. Arthroscopi- cally assisted intra-articular lateral femoral condyle frac- ture surgery. Arthroscopy 2006;22:690.1-4.
• Gliatis J, Kouzelis A, Matzaroglou C, Lambiris E. Ar- throscopically assisted retrodrade intramedullary fixa- tion for fractures of the distal femur: technique, indica- tions and results. Knee Surg Sports Traumatol Arthrosc 2006;14:114-9. CrossRef
• Owens BD, Crane GK, Plante T, Busconi BD. Treatment of type III tibial intercondylar eminence fractures in skel- etally immature athletes. Am J Orthop (Belle Mead NJ) 2003;32:103-5.
• Atesok K, Doral MN, Whipple T, Mann G, Mei-Dan O, Atay OA, et al. Arthroscopy-assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc 2011;19:320-9.