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The outcomes of surgical treatment for lateral Hoffa fracture nonunions

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Lateral Hoffa nonunion are rare injuries. A significant percentage of these nonunions are due to missed acute lateral Hoffa fractures. Operative management of these injuries is difficult and complicated by the presence of bone loss, infection, and soft-tissue contractures. In this study, the aim was to assess clinical and functional outcome in our group of patients with lateral Hoffa nonunion who had undergone operative management and to determine whether variables such as fracture type, infection, and previous surgery affect nonunion/complication rates.

Materials and methods

Data were analyzed for patients with lateral Hoffa nonunion who underwent surgical fixation from January 2008 to December 2020 at a tertiary-care referral center. Patients with lateral condyle Hoffa nonunion and having a minimal follow-up of 1 year were included in this study. Patients with medial Hoffa nonunion, pathological fractures, and children aged less than 16 years were excluded from the study. The fractures were classified by the AO/OTA and Letenneur classification systems. Clinical and functional outcomes were assessed by the Knee society score (KSS) and the lower extremity functional scale (LEFS).

Results

All the 12 patients had united in our series. One patient had reduction failure at 3 months who united after re-fixation. The union rate in our patients was 100%, with a loss of reduction rate of 7.7%, and post-traumatic arthrosis of 7.7%. The average follow-up period was 52.16 ± 27.7 months. The mean knee flexion obtained at the final follow-up was 104.5° (80°–130°). The average KSS clinical score was 80.6 (65–88). The average KSS functional score was 92 (70–100). The average LEFS score was 71 (47–79). There is a statistically significant improvement in the knee range of motion in our patients (p = 0.001). However, no correlation could be detected between variables like type of fracture, infection, and previous surgeries and outcomes.

Conclusions

Lateral Hoffa nonunion can be managed with careful planning of surgical approaches and fixation techniques.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopaedics, Christian Medical College, Vellore, India

    Kaushik Bhowmick, Thilak Samuel Jepegnanam, Dan Barnabas Inja & Manasseh Nithyananth

  2. Department of Biostatistics, Christian Medical College, Vellore, India

    Reka Karuppusami

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  1. Kaushik Bhowmick
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  2. Thilak Samuel Jepegnanam
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Correspondence to Thilak Samuel Jepegnanam.

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Ethical approval

Institutional review board (IRB) (13968, 28.04.2021) approval obtained from Christian Medical College and Hospital, Vellore, India.

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Informed consent was obtained from all individual participants included in the study.

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Bhowmick, K., Jepegnanam, T.S., Inja, D.B. et al. The outcomes of surgical treatment for lateral Hoffa fracture nonunions. Arch Orthop Trauma Surg 143, 2509–2517 (2023). https://doi.org/10.1007/s00402-022-04503-4

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  • DOI: https://doi.org/10.1007/s00402-022-04503-4

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