This 2013 narrative review synthesizes the literature on Hoffa fractures — coronal plane partial articular fractures of the posterior femoral condyle — addressing how to diagnose them reliably, which surgical approaches match specific fracture patterns, and what fixation constructs the biomechanical evidence supports.
When you see a high-energy distal femur fracture — especially an open one — obtain CT routinely: nearly a third of Hoffa fractures are invisible on plain films and the diagnosis will otherwise be made on the table.
When you fix them, orient your screws postero-anteriorly with large-fragment cancellous screws if the approach allows; if you need to preserve arthroplasty options via an anterior approach, use at least two 3.5 mm screws AP to approximate equivalent biomechanical stability.
This 2013 narrative review synthesizes the literature on Hoffa fractures — coronal plane partial articular fractures of the posterior femoral condyle — addressing how to diagnose them reliably, which surgical approaches match specific fracture patterns, and what fixation constructs the biomechanical evidence supports.
When you see a high-energy distal femur fracture — especially an open one — obtain CT routinely: nearly a third of Hoffa fractures are invisible on plain films and the diagnosis will otherwise be made on the table.
When you fix them, orient your screws postero-anteriorly with large-fragment cancellous screws if the approach allows; if you need to preserve arthroplasty options via an anterior approach, use at least two 3.5 mm screws AP to approximate equivalent biomechanical stability.