[Hoffa fractures : Rare, often overlooked, prone to complications].

Abstract

Hoffa fractures are coronal plane fractures of the femoral condyle and overall represent a rare fracture entity. These fractures are predominantly caused by high-energy trauma und usually involve the lateral femoral condyle. An axial load to the femoral condyle with the knee in 90° or more of flexion produces the typical fracture pattern. In the initial radiological diagnostics the fracture is often overlooked, therefore, a computed tomography (CT) examination is indicated for the diagnostics and planning of surgery (selection of the access and the implant). The operative treatment with an equivalent of the Herbert screw achieves a good functional result, which corresponds to the preferred osteosynthesis implant for simple Hoffa fractures without a debris zone. Meniscal, chondral and ligamentous lesions are frequent collateral injuries of Hoffa fractures and can impact on the functional outcome. Therefore, additional magnetic resonance imaging (MRI) diagnostics and intraoperative stability tests are recommended. Despite differentiated diagnostics and management the trajectory of Hoffa fractures is often associated with complications and therefore require a structured rehabilitation protocol and follow-up with radiological controls.