Conjoint bicondylar Hoffa’s fracture with associated supracondylar fracture: A rare case

Abstract

Conjoint bicondylar Hoffa’s fracture is a rare fracture pattern with a coronal split of posterior femoral condyles with an interconnecting bridge of bone. This fracture pattern generally occurs in high-velocity road traffic accidents and is associated with injuries around distal femur, proximal tibia, patella, or extensor mechanism at the knee joint. Due to extensive associated injury patterns, definitive surgical management often varies. This is a case of conjoint bicondylar Hoffa’s fracture with associated comminuted supracondylar fracture of femur. A 40-year-old male presented to the emergency room after sustaining injury to his right knee, previously ambulating on a malunited tibia. Radiographic examination demonstrated conjoint bicondylar Hoffa’s fracture with associated supracondylar fracture right distal femur. Open reduction and internal fixation was done using two T-plates fixed with screws. Due to malunited tibial and fibular fracture with intra-articular extension of the implant, the patient had a decreased range of motion (ROM) up to 120° preoperatively. Early physiotherapy was emphasized, and postoperatively similar ROM was achieved. Conjoint bicondylar Hoffa’s fracture is a rare fracture pattern, which can be associated with a supracondylar fracture of the femur. For this combined fracture fixation, open reduction internal fixation with two T-plates and screws offers a viable treatment option. The patient achieved complete preoperative ROM.