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Hoffa Fragment Associated with a Femoral Shaft FractureA Case Report
Ryan Miyamoto, MD1; Eric Fornari, MS2; Nirmal C. Tejwani, MD3
1 Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003. E-mail address: miyamr01@med.nyu.edu
2 SUNY-Downstate School of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203. E-mail address: Eric.Fornari@downstate.edu
3 Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, 550 First Avenue, NBV 21W37, New York, NY 10016. E-mail address: Nirmal.tejwani@nyumc.org
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, NY

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Oct 01;88(10):2270-2274. doi: 10.2106/JBJS.E.01003
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A coronal plane fracture of the femoral condyle (creating a so-called Hoffa fragment) has been well described in association with fractures of the supracondylar-intercondylar region of the distal part of the femur1. This fracture has implications with regard to preoperative planning, the choice of surgical approach, implant selection, and functional outcomes.Coronal plane fractures of the distal part of the femur are markers of high-energy injury mechanisms. Their presence warrants a thorough workup for other injuries associated with high-energy trauma such as fractures of the spine, pelvis, femoral neck, tibial plateau, ankle, and calcaneus. A Hoffa fracture can often be missed on plain radiographs. Nork et al. showed that up to 30% of coronal plane fractures were missed on plain radiographs of distal femoral fractures, often necessitating the use of computerized tomography for identification and preoperative planning2.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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