Two and Three-Dimensional CT Mapping of Hoffa Fractures

Area of Science:

• Orthopedic surgery
• Radiology
• Biomechanics

Background:

• Hoffa fractures are unstable, intra-articular fractures of the distal femoral condyles.
• Understanding their precise location and comminution patterns is crucial for effective treatment.

Purpose of the Study:

• To map the location and frequency of fracture lines and comminution zones in Hoffa fractures.
• To utilize 2D and 3D computed tomography (CT) mapping for detailed analysis.

Main Methods:

• Retrospective review of 75 Hoffa fractures (OTA/AO types 33B3.2 and 33B3.3).
• Characterization of fracture lines in axial and sagittal CT planes.
• Superimposition of CT images onto a standard template for 2D and 3D mapping.

Main Results:

• Lateral femoral condyle fractures were more frequent (48 vs 26 medial).
• Fracture lines concentrated in the middle third of the lateral condyle, with greater variation medially.
• 3D mapping identified comminution zones in the weight-bearing area of the lateral condyle's articular surface.

Conclusions:

• Hoffa fractures predominantly affect the lateral femoral condyle.
• Fracture patterns vary between medial and lateral condyles in axial and sagittal planes.
• Articular comminution, particularly in the weight-bearing zone, is common in lateral Hoffa fractures, informing surgical approaches and fixation strategies.