Orthopaedic Surgery, Fukuoka University, Fukuoka, Japan.
Orthopaedic Surgery, Fukuoka University, Fukuoka, Japan
BMJ Case Rep. 2021 Feb 4;14(2):e238615. doi: 10.1136/bcr-2020-238615.
Hoffa fractures are unstable intra-articular fractures of the femoral condyle that occur in the coronal plane.Insufficient anatomical reduction and internal fixation may lead to non-union or malunion. A 39-year-old man was involved in a traffic accident while riding a motorcycle and was diagnosed with left Hoffa fracture and avulsion fracture of the femoral attachment of the medial collateral ligament. Open reduction and internal fixation were performed 5 days after injury. The patient experienced intermittent knee pain, joint contracture and deformity, and attended our hospital for further treatment 18 months after surgery. CT revealed depression and malunion of the posterior aspect of the lateral femoral condyle, and weight-bearing X-ray showed valgus deformity due to malunion. Distal femoral osteotomy (DFO) was performed and good functional and radiographic results were obtained. This report suggests that DFO is a reasonable treatment for young patients suffering from malalignment due to malunited Hoffa fracture.
Hoffa 骨折是发生在冠状面的股骨髁关节内不稳定骨折。解剖复位不足和内固定不当可能导致骨折不愈合或畸形愈合。一名 39 岁男性在骑摩托车时发生交通事故，被诊断为左 Hoffa 骨折和内侧副韧带股骨附着处撕脱骨折。受伤后 5 天进行了切开复位内固定。患者术后 18 个月出现间歇性膝关节疼痛、关节挛缩和畸形，来我院进一步治疗。CT 显示外侧股骨髁后侧面凹陷和畸形愈合，负重 X 线显示由于畸形愈合导致的外翻畸形。行股骨远端截骨术（DFO），获得了良好的功能和影像学结果。本报告提示对于因 Hoffa 骨折畸形愈合导致对线不良的年轻患者，DFO 是一种合理的治疗方法。
