Khatri S S, Shekhawat Namrata
Robotics by Khatri, Jaipur, Rajasthan, India.
J Orthop Case Rep. 2025 Sep;15(9):52-55. doi: 10.13107/jocr.2025.v15.i09.6012.
Coronal plane fractures of the femoral condyle, known as Hoffa's fractures, are uncommon intra-articular injuries. Non-union of such fractures is rarely reported, particularly in younger patients, and presents a complex clinical scenario.
A case of a 38-year-old male who reported chronic right knee pain, swelling, and difficulty in ambulation due to a non-union Hoffa's fracture. Radiological findings indicated joint surface degeneration and instability. Given the chronicity and extent of articular damage, the patient underwent total knee arthroplasty (TKA) along with open reduction and internal fixation (ORIF) of the medial femoral condyle under spinal anesthesia. A posterior-stabilized knee system (Smith and Nephew, femur-5, tibia-5, polyethylene insert 13 mm) was implanted using Palacos bone cement. The patient recovered well and regained mobility with significant pain relief.
In rare cases of non-union Hoffa's fractures with joint degeneration, combined TKA and ORIF can provide functional improvement and pain relief, even in younger adults, when performed with appropriate surgical planning.
股骨髁冠状面骨折，即霍法骨折，是一种少见的关节内损伤。此类骨折不愈合的情况鲜有报道，尤其是在年轻患者中，且呈现出复杂的临床情况。
一名38岁男性患者，因霍法骨折不愈合而出现右膝慢性疼痛、肿胀及行走困难。影像学检查结果显示关节面退变及不稳定。鉴于关节损伤的慢性病程及程度，患者在脊髓麻醉下接受了全膝关节置换术（TKA）以及股骨内侧髁切开复位内固定术（ORIF）。使用帕拉科斯骨水泥植入了后稳定型膝关节系统（施乐辉公司，股骨-5，胫骨-5，聚乙烯内衬13毫米）。患者恢复良好，疼痛明显缓解，恢复了活动能力。
在伴有关节退变的霍法骨折不愈合的罕见病例中，当进行适当的手术规划时，联合TKA和ORIF即使在年轻成年人中也能改善功能并缓解疼痛。
