|Beitragstitel||Salter-IV fractures of the medial femoral condyle in a 15 year old boy. A case report|
Introduction: Hoffa Fractures are rare injuries of the femoral condyles, which typically occur on the medial side.
Since there is a lack of bony contact of the distal fragment, these injuries are associated with an increased risk of pseudarthrosis or avascular necrosis.
Therefore, this intraarticular fracture has to be treated by anatomical reposition and stable fixation under compression.
We report on a 12-year old boy who presented with a Salter-IV-fracture of the medial femur condyle.
The fracture line was not in the sagittal plane, like common Salter IV fractures, but in the coronar plane, similar to a Hoffa fracture of an adult.
This type of fracture is rare and - to our knowledge- hardly described in children.
Methods: In December 2016 a 15 year old boy presented to our emergency unit after he was hit by a bus.
No additional injures, no known comorbidities. Physical examination was inconclusive because of pain. After conventional X-ray, a CT was performed and the fracture was diagnosed. We saw the indication for an arthroscopically assisted fixation of the medial femoral condyle with cannulated screws.
Results: We were able to achieve an anatomical reposition with compression of the fracture. For the aftercare, we applied a thigh cast for six weeks. We will be presenting the results of clinical and radiological follow-up.
Discussion: Fractures of the medial femoral condyle are rare. Since these fractures are intraarticular, a correct anatomical reposition is necessary. Arthroscopically assisted internal fixation is recommended for adults. After extensive literature research we were able to identify only one case in which this fracture was reported in a child. There, an open procedure was performed. We anticipate that arthroscopically assisted reduction and internal fixation is leading to less tissue damage than open surgery
Conclusion: In this case, treatment of a Hoffa fracture could be performed by arthroscopically assisted internal fixation, comparable to the treatment of Hoffa fractures in adults.