Hoffa fracture is a type of supracondylar distal femoral fracture and is characterised by an associated fracture component in the coronal plane.
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While they are rare in absolute numbers, they can account for approximately 40% of intercondylar fractures. It is typically seen in adults after higher-energy trauma 4.
Hoffa fractures are intra-articular and are characterised by a fracture in the coronal plane.
Hoffa fragments are more commonly unicondylar and usually originate from the lateral femoral condyle. They can be occasionally bicondylar.
Initially imaging evaluation of Hoffa fractures (as with other distal femoral fractures) is usually with conventional radiographs. The fracture line in the coronal plane is classically shown.
Pre oprative CT evaluation is considered to be useful particualrly to assess the fracture pattern 1.
Treatment and prognosis
At the time of writing, they are thought to be best treated by anatomical reduction and rigid fixation followed by early mobilisation 2.
History and etymology
It was initially described by Hoffa in 1904, who also described Hoffa's fat pad.
- 1. Baker BJ, Escobedo EM, Nork SE et-al. Hoffa fracture: a common association with high-energy supracondylar fractures of the distal femur. AJR Am J Roentgenol. 2002;178 (4): 994. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Gavaskar AS, Tummala NC, Krishnamurthy M. Operative management of Hoffa fractures--A prospective review of 18 patients. Injury. 2011;42 (12): 1495-8. doi:10.1016/j.injury.2011.09.005 - Pubmed citation
- 3. Vaishya R, Singh AP, Dar IT et-al. Hoffa fracture with ipsilateral patellar dislocation resulting from household trauma. Can J Surg. 2009;52 (1): E3-4. Can J Surg (link) - Free text at pubmed - Pubmed citation
- 4. Flanagin BA, Cruz AI, Medvecky MJ. Hoffa fracture in a 14-year-old. Orthopedics. 2011;34 (2): 138. doi:10.3928/01477447-20101221-30 - Pubmed citation
- 5. Thakar C. The Hoffa fracture--a fracture not to miss. Emerg Med J. 2010;27 (5): 391-2. doi:10.1136/emj.2009.087213 - Pubmed citation
- 6. Allmann KH, Altehoefer C, Wildanger G et-al. Hoffa fracture--a radiologic diagnostic approach. J Belge Radiol. 1996;79 (5): 201-2. - Pubmed citation