Neglected Hoffa fracture in a child.

The clinical presentations and surgical outcome of a 4-month-old Hoffa fracture in a 12-year-old child are reported. The child presented with chronic pain, swelling and instability in the right knee joint. Lateral radiograph showed a small bone fragment on the posterior condyle, which raised the possibility of a fracture. Computed tomographic scan and MRI clearly delineated the coronal plane fracture of the lateral femoral condyle that had spared the physeal cartilage. The fracture was accessed through the posterolateral approach to the knee; the fragment was anatomically reduced and fixed with two partially threaded cancellous screws. Radiographic union was observed after 3 months, and after 2 years of follow-up, the child had excellent functional outcome.