The Hoffa-like fracture of the tibial plateau: a clinical study

Given the contrapositive link between the posterior tibial plateau and the femoral condyle and the similar injury cause, the fracture type should be the same as the well-known Hoffa fracture of the femoral condyle. This study aims to report a case series with Hoffa-like tibial plateau fractures to improve understanding.

We analysed six consecutive patients presented with Hoffa-like tibial plateau fractures in our hospital between October 2014 and December 2020, a period in which 1924 tibial plateau fractures were treated. Patients' data on demographics, radiographs, surgical therapy, and assessment at a 12-month follow-up were retrieved.

The incidence of Hoffa-like tibial plateau fractures was 0.31% (6/1924). This study included three men and three women, with a mean age of 45.8 years. The injury mechanism was either a fall from a great height or a vehicle accident. On average, 7.5 days after the injury, patients were surgically treated with open reduction and internal fixation (ORIF) with place/screws via a lateral or posteromedial approach. At 10 to 15 weeks, all instances had osseous union on radiography. At 12-month follow-up, the HSS score of the operated knee ranged from 93 to 98 points (mean: 94.8), and Rasmussen radiograph score was from 15 to 18 (mean: 15.8). There were no intra-operative or post-operative problems.

This Hoffa-like fracture of the tibial plateau is a rare condition; however, it can occur. Orthopaedic surgeons should pay attention to this neglected but actually familiar fracture type.