Coronal fractures of the femoral condyle: a brief report of five cases

Coronal fractures of the femoral condyle (Hoffa fractures) are uncommon injuries that have a better outcome when treated surgically. We report a series of five Hoffa fractures (including one nonunion) treated at a Level 1 trauma center by one surgeon employing a protocol of open reduction and internal fixation with lag screws through a formal parapatellar approach. Postoperatively, all patients began immediate unrestricted range of motion. Initial weight bearing was limited, but all patients were permitted full weight bearing by 10 weeks. All fractures healed within 12 weeks without complications. The final range of motion for the patients with acute fractures was at least 0 degrees to 115 degrees. The patient with a nonunion had a preoperative flexion contracture of 20 degrees and a final range of motion of 20 degrees to 125 degrees. Long-term follow-up (average 37 months, range 18-57 months) was available for 3 of the 5 patients, and Knee Society scores were calculated for these patients (average 173 of 200 points, range 160-180 points). The literature regarding the management of Hoffa fractures is reviewed.