Reverse-Applied Proximal Tibia Plate for Fixation of Hoffa Fractures

In the treatment of Hoffa fractures, combining screws with a lateral plate achieves more stable fixation and favorable outcomes. Here we present a case of Hoffa fracture fixation in which an "L"-shaped contralateral proximal tibia plate was applied in reverse, together with screws, resulting in good postoperative results.

Case

Preoperative planning for fixation of a Hoffa fracture using a contralateral lateral tibial plateau plate (see figure).   

a and b: Right tibial plate; c and d: Left femoral Hoffa fracture.

Following surgical exposure, the fracture was fixed with an L-shaped contralateral tibial plate combined with three 5.0 mm screws.

After fixation, satisfactory knee stability was achieved from full extension to flexion.

Conventional straight or reconstruction plates allow only a limited number of screws for fixation of the Hoffa fragment. The lateral tibial plate requires no pre-bending, and the three orthogonally oriented locking screws ensure adequate stability. This technique can be recommended.