Missed Medial Condyle Hoffa Fracture in a Case of Lateral Condyle Hoffa Fracture

INTRODUCTION: The Hoffa fracture is an uncommon coronal plane fracture involving the femoral condyles. The coronal nature of the fracture makes it hard to diagnose clinic-radiologically. CASE REPORT: A 42-year-old male patient developed pain associated with swelling in his right knee after a two-wheeler accident. He consulted his general practitioner who missed the Hoffa fracture on plain radiographs and treated him conservatively with analgesics. The pain did not subside and he visited our emergency department where a computed tomography (CT) scan revealed a Hoffa fracture of the lateral condyle. He was taken up for open surgery, and while fixing the lateral condylar fracture, we found an undisplaced medial condylar Hoffa fracture of the ipsilateral femur. This fracture was initially missed on the CT scan. Both the fractures were internally fixed and the patient was put on rehabilitation. At the end of the 6-month follow-up, the patient had a full knee range of motion. CONCLUSION: Careful and detailed CT imaging and looking for fractures other than Hoffa is important, so as not to miss any associated bony injuries. Furthermore, the treating surgeon needs to look for other bony injuries during open or arthroscopic fixation of Hoffa’s fracture.