Nastov Nebojsha, Bekteshi Labinot, Nikolovski Andrej
Department of Traumatology, University Surgery Hospital "St. Naum Ohridski" Skopje 1000, North Macedonia.
Ss. Cyril and Methodius University in Skopje 1000, North Macedonia.
J Surg Case Rep. 2024 Jan 3;2024(1):rjad706. doi: 10.1093/jscr/rjad706. eCollection 2024 Jan.
Coronal-plane intra-articular fractures of the femoral condyle (Hoffa fractures) are rare, and difficult to diagnose and treat. They mostly result as a consequence of high-energy trauma and are combined with concomitant fractures (patellar, tibia shaft) and/or soft-tissue damage. A plain X-ray can miss the diagnosis initially and therefore computerized tomography scan is recommended, which can also help in the preoperative planning. The vast majority of these fractures are unicondylar (mostly lateral condyle fractured). The approach for their treatment can be anterior or posterior. In cases of fracture comminution, much more mutilant approaches with osteotomy have been described. A combined two-stage approach can be used to obtain anatomical reduction and fixation of all the fragments. We present a case of a 46-year-old male patient with comminuted lateral Hoffa fracture treated with a combined approach (extended posterior approach to the proximal tibia and lateral parapatellar) in a time interval of one month.
股骨髁冠状面关节内骨折（霍法骨折）较为罕见，诊断和治疗都很困难。它们大多由高能创伤导致，并伴有其他骨折（髌骨、胫骨干骨折）和/或软组织损伤。普通X线最初可能漏诊，因此建议进行计算机断层扫描，这也有助于术前规划。这些骨折绝大多数为单髁骨折（大多为外侧髁骨折）。其治疗方法可以是前路或后路。对于骨折粉碎的情况，有更多采用截骨术的致残性更高的手术入路被描述。可以采用联合两阶段手术入路来实现所有骨折块的解剖复位和固定。我们报告一例46岁男性患者，其外侧霍法骨折粉碎，采用联合手术入路（胫骨近端延长后路和髌旁外侧入路），手术间隔时间为1个月。
