Hoffa fracture: analysis of factors affecting the final outcome after treatment with partially threaded screws


  • Ramprakash Lohiya Department of Orthopaedics, 1S.P. Medical College and Associated group of PBM Hospitals, Bikaner, Rajasthan
  • Nipun Jindal Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, Punjab
  • Vikas Bachhal Department of Orthopaedics, Postgraduate Institute of Medical Education &Research, Chandigarh, Punjab
  • Sudhir Kumar Garg Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, Punjab
  • Sabyasachi Bhowmik Department of Orthopaedics, Giansagar Medical College and Hospital, Banur, Rajpura, Punjab




Hoffa fracture, Coronal fractures, Femoral condyles, Outcome, Partially threaded screws


Background: Coronal fractures of the femoral condyles are rare injuries.

Methods: This retrospective case series included patients with coronal fractures of the femoral condyles managed operatively. The surgeries were performed by authors NJ, RL and VB. A total of 11 patients with Hoffa fracture were operated between May 2011 and July 2012.

Results: We report the outcome of open reduction and internal fixation using partially threaded screws in 11 patients with Hoffa fracture. There were 10 male and 1 female patient operated at a mean age of 37 years. The average duration of follow up was 15.6 months. Fractures in all the patients united with a mean 115.450 range of flexion at knee at final review. The final outcome had a poor correlation with the shear angle of the fracture but fracture comminution and open nature of injury had a negative effect on the final outcome achieved. The number of screws used and the type of rehabilitation followed post operatively also had no bearing on the final range of motion achieved.

Conclusions: Partially threaded screws offer consistently good results in coronal fractures of the femoral condyles and the outcome is dictated only by perioperative factors like comminution and open nature of injury.


Payne R, Clark D, Wall S. Union after delayed presentation of a Hoffa fracture. Injury Extra. 2005;36(7):289-91.

Lewis SL, Pozo JL, Muirhead-Allwood WFG. Coronal fractures of the lateral femoral condyle. J Bone Joint Surg (Br). 1989;71:118–20.

Ostermann PAW, Neumann K, Ekkernkamp A, Muhr G. Long term results of unicondylar fractures of the femur. J Orthop Trauma.1995;8(2):142-6.

Holmes SM, Bomback D, Baumgaertner MR.Coronal fractures of the femoral condyle: a brief report of five cases. J Orthop Trauma. 2004;18(5):316-9.

Cheng PL, Choi SH, Hsu YC. Hoffa fracture: should precautions be taken during fixation and rehabilitation? Hong Kong Med J. 2009;15(5):385-7.

Mak W, Hunter J, Escobedo E. Hoffa Fracture of the Femoral Condyle. Radiol Case Reports. 1998;3:231.

Annamalai SKM, Berstock JR, Shannon MN. The Hoffa Fracture: a case report. BJMP. 2008;1(2):36-7.

Kumar R, Malhotra R. The Hoffa fracture: Three case reports. J Orthop Surg. 2001;9(2):47–51.

Thakar C. The Hoffa Fracture- a fracture not to miss. Emerg Med J. 2010;27(5):391-2.

Manfredini M, Gildone A, Ferrante R. Unicondylar femoral fractures: therapeutic strategy and long-term results. Acta Orthop Belg. 2001; 67:132-8.

Becker PL, Staford PR, Goulet R. Comparative analysis for the fixation of coronal distal intraarticu1ar femur fractures. Presented at the 67th annual meeting of the American Academy of Orthopaedic Surgeons. 2000;15-19:2000.

Jarit GJ, Kummer FJ, Gibber MJ, Egol KA.A mechanical evaluation of two fixation methods using cancellous screws for coronal fractures of the lateral condyle of the distal femur (OTA type 33B). J Orthop Trauma. 2006;20(4):273-6.

Hoffa A. 4th ed. Stuttgart: Ferdinand Enke-Verlag. Lehrbuch der Frakturen und Luxationen; 1904:453.

Nork SE, Segina DN, Aflatoon K. The association between supracondylar-intercondylar distal femoral fractures and coronal plane fractures. J Bone Joint Surg Am. 2005.;87-A(3):564-9.

Wallenbock E, Ledinski C. Indications and limits of arthroscopic management of intraarticular fractures of the knee joint [German]. Aktuelle Traumatol. 1993;23:97-101.

Letenneur J, Labour PE, Rogez JM. Fractures de Hoffa: a propos de 20 observations. Ann Chir. 1978;32:213-9.






Original Research Articles