Hoffa’s fracture in an adolescent treated with an innovative surgical procedure: A case report

doi:10.12998/wjcc.v10.i4.1410

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Feb 6, 2022; 10(4): 1410-1416
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1410

Hoffa’s fracture in an adolescent treated with an innovative surgical procedure: A case report

Zu-Xin Jiang, Pan Wang, Shun-Xin Ye, Xiao-Ping Xie, Chun-Xiu Wang, Yue Wang

Zu-Xin Jiang, Pan Wang, Shun-Xin Ye, Xiao-Ping Xie, Department of Orthopaedics, No. 2 People’s Hospital of Yibin City, Yibin 644000, Sichuan Province, China

Chun-Xiu Wang, Department of Oncology, No. 2 People’s Hospital of Yibin City, Yibin 644000, Sichuan Province, China

Yue Wang, Department of Orthopedics, Sichuan Provincial People's Hospital, Chengdu 640000, Sichuan Province, China

Author contributions: Jiang ZX was the patient’s surgeon, reviewed the literature and contributed to manuscript drafting; Wang P reviewed the literature and contributed to manuscript drafting; Ye SX and Xie XP analyzed and interpreted the imaging findings; Wang CX reviewed the literature; Wang Y analyzed and interpreted the imaging findings and revised the manuscript; all the authors issued final approval for the version to be submitted.

Informed consent statement: The patient and her parents provided consent for the publication of the images.

Conflict-of-interest statement: The authors have no conflict of interest to disclose.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Yue Wang, MD, PhD, Chief Doctor, Department of Orthopedics, Sichuan Provincial People's Hospital, No. 32 West Second Section, First Ring Road, Qingyang District, Chengdu 640000, Sichuan Province, China. wangyue1957vip@163.com

Received: September 3, 2021
Peer-review started: September 3, 2021
First decision: October 29, 2021
Revised: November 10, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: February 6, 2022
Processing time: 143 Days and 4.8 Hours

Abstract

BACKGROUND

Hoffa fracture is rare, especially in adolescents, and has a high rate of complications such as avascular necrosis and osteoarthritis; moreover, there are no definitive guidelines for its treatment. This report could provide a new potential treatment for Hoffa fracture.

CASE SUMMARY

A 16-year-old girl presented to the orthopedic emergency department of No. 2 People’s Hospital of Yibin City with persistent pain following a right knee injury sustained during a sprint race. Her knee was swollen and tender, and the range of motion was restricted by the pain. X-ray and computed tomography revealed a Hoffa fracture in the right knee. After consultation, surgical treatment was performed, and the fracture was fixed with three 3.5-mm cannulated cancellous screws; osteochondral plugs that were harvested from the screw insertion site were re-implanted to cover the screw head. The patient’s fracture and osteochondral plug healed 6 mo postoperatively, and she presented a knee range of motion of 0–135 without pain, and was walking without support with a normal gait.

CONCLUSION

Here, we describe an innovative surgical procedure for Hoffa fracture that could provide a new possibility for the treatment of similar fractures, and further improve their management.

Keywords: Hoffa fracture; Osteochondral plug; Open reduction; Internal fixation; Case report

Core Tip: A 16-year-old girl presented to our orthopedic emergency department with persistent pain following a right knee injury sustained during a sprint race. On examination, the right knee was swollen and tender with decreased range of motion. Laboratory examination revealed no obvious abnormality. She was treated by open reduction and internal fixation with osteochondral plug re-implantation, and had no postoperative complications. The fracture and osteochondral plug had completely healed, 6 mo postoperatively.