[Difficulties involved in the Hoffa fractures]

To study the outcome in Hoffa fractures regarding the type of fracture, concomitant injuries, and different treatments. From January 1996 until December 2002, 7 Hoffa fractures (6 patients) from a total of 79 distal femoral fractures were treated in the Department of Trauma Surgery, University Hospital of Giessen. The results were evaluated by Neer's score. For the evaluation of postoperative vascularization of the distal femur, clinical and radiological findings were compared with anatomical studies of the bone arteries by corrosion preparations. Fracture consolidation was seen in all cases. Patients with an isolated Hoffa fracture achieved a score of 89.0 (82-97) according to Neer. One patient suffering initially from nonunion achieved 68 points after bone union. One polytraumatized patient with bilateral Hoffa fracture achieved a satisfying result (score value of 72) and a bad result (score value of 38). Multiple small nutrient arteries of the distal femur originate from the "rete articulare genus." They can be expected to ensure the arterial blood supply. Hoffa fracture is a very rare injury. In our patients, careful surgical treatment with open reduction and safe screw fixation yielded good to very good results.