All arthroscopic management of an Hoffa fracture of the medial femoral condyle: case report

Hoffa fractures are intra-articular fractures of the distal femur in the coronal plane, with an incidence of approximately 0,65 % of all femoral fractures. Isolated fractures of the medial condyle are even less frequently reported. The most frequent mechanism associated is an axial load exerted on a flexed knee. Diagnosis of this fracture might be challenging as standard radiographic studies may appear normal. Due to their intra-articular location, anatomical reduction of this fractures must be achieved and articular congruence restored for the patient to achieve optimal functional results. The authors present a case of a 38-year-old male patient who sustained a high energy trauma to his right knee. A comminutive Hoffa fracture of the medial femoral condyle was identified. No neurovascular compromise was identified. Arthroscopic reduction of the main fragments was performed followed by fixation with three screws. A posteromedial portal was needed to achieve anatomic reduction. Weight-bearing was allowed at 8 weeks and physical therapy initiated. Six months after the patient had full return to his previous activity level. Anatomical reduction and stable osteosynthesis are required for the management of Hoffa fractures. Arthroscopic management of these lesions is as a successful method, providing good outcomes with few complications associated.