Journal of orthopaedic case reports · 2025
Posterior Approach for Single-stage Fixation of Medial Hoffa with Posterior Cruciate Ligament Avulsion: A Rare Case Report.
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Katzir Alona, Gordon Max, Weil Yoram A, Jammal Mahmoud
Аннотация
INTRODUCTION: Medial Hoffa fractures are rare intra-articular injuries of the femoral condyle, and their association with posterior cruciate ligament (PCL) avulsion fractures presents a highly uncommon and complex clinical scenario. This case report describes the successful surgical management of such a combination using a posterior open approach.
CASE REPORT: A 48-year-old male sustained a medial Hoffa fracture with a PCL avulsion following a road traffic accident. Surgical intervention involved open reduction and internal fixation (ORIF) through a posterior approach, allowing direct access to both fracture sites. The PCL avulsion fragment was anatomically reduced and fixed with a cancellous screw, while the Hoffa fracture was stabilized using opposing Herbert screws. Postoperatively, the patient underwent structured rehabilitation with an early range of motion exercise. At 6 months, the patient achieved full knee function (0-130°), no instability, and high functional scores. Radiographs showed complete union, and follow-up at 18 months confirmed maintained function without complications.
CONCLUSION: This case highlights the effectiveness of a posterior approach for single-stage ORIF in managing rare medial Hoffa fractures with PCL avulsion. Early surgical intervention, anatomical fixation, and dedicated rehabilitation are key to achieving optimal outcomes in such complex knee injuries.
CASE REPORT: A 48-year-old male sustained a medial Hoffa fracture with a PCL avulsion following a road traffic accident. Surgical intervention involved open reduction and internal fixation (ORIF) through a posterior approach, allowing direct access to both fracture sites. The PCL avulsion fragment was anatomically reduced and fixed with a cancellous screw, while the Hoffa fracture was stabilized using opposing Herbert screws. Postoperatively, the patient underwent structured rehabilitation with an early range of motion exercise. At 6 months, the patient achieved full knee function (0-130°), no instability, and high functional scores. Radiographs showed complete union, and follow-up at 18 months confirmed maintained function without complications.
CONCLUSION: This case highlights the effectiveness of a posterior approach for single-stage ORIF in managing rare medial Hoffa fractures with PCL avulsion. Early surgical intervention, anatomical fixation, and dedicated rehabilitation are key to achieving optimal outcomes in such complex knee injuries.