Operative Management of Hoffa Fracture of the Femoral Condyle

  • Ramji Lal Sahu Mail Department of Medical Laboratory Sciences, Faculty of Paramedicine, SMS&R, Sharda University U.P. New Delhi, India.
  • Pratiksha Gupta Department of Medical Laboratory Sciences, Faculty of Paramedicine, PGIMS &R ESIC, Basaidarapur, New Delhi, India.
Hoffa fractures, Distal femur, Unicondylar fractures, Tangential fractures


Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur and only very few cases have been reported in the literature. These fractures are due to high energy trauma and conservative treatment generally yields poor results, but rigid internal fixation allows early functional rehabilitation and decreases the incidence of complications. The purpose of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment. From July 2005 to July 2010, 22 patients (14 males and 8 females) were recruited from Emergency and outpatient department having closed and open Hoffa fracture of the femoral condyle. All patients were operated under general or spinal anesthesia. Post-operatively, all the patients were followed for 12 months. Fractures were united in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of fracture pattern. Fractures were reduced anatomically in all except in one patient. During follow-up, there were no losses of reduction or fixation. Full weight bearing were started in the mean time of 8.8 weeks. Mean duration of hospital stay were 9.8 days. Complications were stiffness and pain in one patient, collateral laxity in one patient and progression of arthritis in one patient. The results were excellent in 90.90% and good in 9.09% patients. Finally, we conclude that the early anatomical reduction and rigid fixation with screws provide best results and minimal complications.


Hoffa A, editor. Lehrbuch der Frakturen und Luxationen fur Arzte. 4th ed. Stuttgart: Verlag von Ferdinand Enke; 1904: p. 451.

Letenneur J, Labour PE, Rogez lM, et al. Fractures de Hoffa: a propos de 20 observations. Ann Chir 1978;32(3-4):213-9.

Lewis SL, Pozo JL, Muirhead-Allwood WFG. Coronal fractures of the lateral femoral condyle. J Bone Joint Surg Br 1989;71(B):118-20.

Manfredini M, Gi1done A, Ferrante R, et al. Unicondy1ar femoral fractures: therapeutic strategy and long-term results. Acta Orthop Belg 2001;67(2):132-8.

McDonough PW, Bernstein RM. Nonunion of a Hoffa fracture in a child. J Orthop Trauma 2000;14(7):519-21.

Heuschen UA, Gohring U, Meeder PJ. Die beidseitige Hoffa-Fraktureine Raritat. Aktuelle Traumatol 1994;24(3):83-6.

Zeebregts CJ, Zimmerman KW, ten Duis HJ. Operative treatment of a unilateral bicondy1ar fracture of the femur. Acta Chir Belg 2000;100:1104-6.

Baker BJ, Escobedo EM, Nork SE, et al. Hoffa fracture: a common association with high-energy supracondylarfractures ofthe distal femur. AJR Am J Roentgenol 2002;178(4):994.

Wallenbock E, Ledinski C. Indications and limits of arthroscopic management of intraarticular fractures of the Knee joint. Aktuelle Traumatol 1993;23(2):97-101.

Allmann KH, A1tehoefer C, Wi1danger G, et al. Hoffa fracture-a radiologic diagnostic approach. J Belg Radiol 1996;79(5):201-2.

Muller ME, Nazarian S, Koch P, et al, editors. The Comprehensive Classification of Fractures of Long Bones. 1st ed. Berlin: Springer-Verlag; 1994: p. 144-5.

Orthopaedic Trauma Association Committee for Coding and Classiflcation. Fracture and Dislocation Compendium: distal femur fractures. J Orthop Trauma 1996;10(Supp1):45.

Browner BD, Jupiter JB, Levine AM, et al. Skeletal Trauma. 2nd ed. Philadelphia, PA: WB Saunders; 1998: p. 1639-40.

Muller ME, Allgower M, Schneider R, et a1. Manual ofInternal Fixation. 3rd ed. NewYork, NY: Springer- Verlag; 1995: p. 549.

Schatzker J, Tile M. The Rationale of Operative Fracture Care. 2nd ed. Berlin: Springer-Verlag; 1996: p. 390-1.

McCarthy JJ, Parker RD. Arthroscopic reduction and internal fixation of a displaced intraarticular lateral femoral condyle fracture of the lmee. Arthroscopy 1996;12(2):224-7.

Stern RE. Comment. Arthroscopy 1996;12(6):760-1.

Ostermann PA, Hahn MP, Ekkernkamp A, et al. Monocondy1are Frakturen des Femur. Oururg 1997;68(1):72-6.

Liebergall M, Wilber JH, Mosheiff R, et al. Gerdy's tubercule osteotomy for the treatment of coronal fractures of the lateral femoral condyle. J Orthop Trauma 2000;14(3):214-5.

Becker PL, Staford PR, Goulet R, et al. Comparative analysis for the fixation of coronal distal intraarticu1ar femur fractures. Proceedings of the 67th annual meeting of the American Academy of Orthopaedic Surgeons. Orlando: FL. 15-19. Feb 2000.

Gavaskar AS, Tummala NC, Krishnamurthy M. Operative management of Hoffa fractures—a prospective review of 18 patients. Injury 2011;42(12):1495-8.

Iwai, Hamada M, Miyama T, et al. Intra-articular corrective osteotomy for malunited Hoffa fracture: A case report. Sports Med Arthrosc Rehabil Ther Technol 2012;4(1):28.

Viskontas DG, Nork SE, Barei DP, et al. Technique of Reduction and Fixation of Unicondylar Medial Hoffa Fracture. Am J Orthop 2010;39(9):424-8.

How to Cite
Sahu RL, Gupta P. Operative Management of Hoffa Fracture of the Femoral Condyle. Acta Med Iran. 52(6):443-447.