Hoffa fractures are slower to heal than entire condyle fractures of the distal femur: an analysis of type 33B fractures

Eur J Orthop Surg Traumatol. 2024 Dec 12;35(1):38. doi: 10.1007/s00590-024-04118-y.

Abstract

Purpose: To examine patient demographic and clinical outcomes associated with partial articular distal femoral fractures.

Methods: An IRB-approved study was conducted on a consecutive series of patients being treated for isolated partial articular distal femoral fractures at a single academic medical center between August, 2011 and July, 2023. Patient demographics, hospital quality measures and outcomes for each patient were reviewed. All fractures were fixed using screws alone or plate and screw constructs. Fractures were grouped into isolated entire medial or lateral condyle (OTA/AO 33B1 or B2) and posterior unicondylar (Hoffa) fractures (OTA/AO 33B3.2). Cohorts were compared for clinical, radiographic and complication outcomes using Chi-Square Tests and ANOVA tests.

Results: A total of 30 patients were identified with a mean of 55.2 years. There were 16 (53.3%) isolated medial/lateral condylar fractures and 14 (46.7%) Hoffa fractures. There were no differences between the two fracture types in terms of baseline demographics. There was no difference in terms of length of stay or in-hospital complications between the fracture types. All fractures united. There was also no difference in range of knee motion at latest follow-up visit. Hoffa fractures required a longer time for radiographic healing (4.5 months vs. 3.05 months, p = 0.012).

Conclusion: Hoffa fractures require longer time to radiographic healing compared to other partial articular distal femoral fractures; however no other differences were seen based on fracture patterns.

Level of evidence: III.

Keywords: Distal femur fracture; Fracture healing; Hoffa fracture; Isolated distal condylar fracture.

MeSH terms

  • Adult
  • Aged
  • Bone Plates
  • Bone Screws
  • Female
  • Femoral Fractures* / classification
  • Femoral Fractures* / diagnostic imaging
  • Femoral Fractures* / surgery
  • Fracture Fixation, Internal* / adverse effects
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Fracture Healing*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Retrospective Studies