Bicondylar hoffa fracture successfully treated with headless compression screws.

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Hoffa fractures, or bicondylar coronal plane fractures of the distal femur, are exceptionally rare injuries.
• These fractures involve both femoral condyles in the coronal plane, posing unique challenges for treatment.
• Isolated unilateral bicondylar Hoffa fractures are particularly uncommon, necessitating careful surgical consideration.

Purpose of the Study:

• To present a case of isolated unilateral bicondylar Hoffa fracture.
• To describe the successful surgical management of this rare injury.
• To evaluate the efficacy of open reduction and internal fixation using headless compression screws.

Main Methods:

• A case of isolated unilateral bicondylar Hoffa fracture was identified.
• The fracture was treated with open reduction and internal fixation.
• Posteroanteriorly oriented Acutrak screws were inserted perpendicular to the fracture plane via a lateral parapatellar arthrotomy.

Main Results:

• The surgical intervention resulted in satisfactory outcomes.
• Excellent compression across the fracture site was achieved using the headless compression screws.
• The chosen surgical approach and fixation method proved effective for this rare fracture pattern.

Conclusions:

• Isolated unilateral bicondylar Hoffa fractures, though rare, can be successfully managed with open reduction and internal fixation.
• Headless compression screws, particularly when inserted perpendicular to the fracture plane, provide effective fixation and compression.
• Lateral parapatellar arthrotomy is a viable surgical approach for accessing and treating these complex distal femur fractures.