Hoffa Fracture Letenneur Type II

Description

The presentation by Ashok Gavaskar focuses on the surgical management of Letenneur type 2 and type 4 fractures. Gavaskar begins by explaining the characteristics of Letenneur type 2 fractures, which are defined by their fracture lines that run parallel to the posterior femoral condyle, and are further classified into types A, B, and C based on soft tissue attachments. He discusses the surgical approaches, emphasizing that the choice of exposure—whether supine, lateral, or prone—depends on the fracture's characteristics and location.



He elaborates on specific surgical techniques, advocating for anterior-based approaches like the swashbuckler and various parapatellar approaches, while detailing his preferred method of performing a Gerdy tubercle osteotomy combined with a swashbuckler approach for better access and fixation on lateral type 2 and 4 injuries.



Gavaskar presents case studies showcasing his techniques, describing the use of AP screws combined with mini fragment plates for effective fixation. He explains that for type 2c fractures, which lack soft tissue attachment, a posterolateral approach may be necessary. He also covers the importance of fracture reduction techniques, which are influenced by the type of fracture, and emphasizes the importance of careful soft tissue management to avoid devascularization. The talk concludes with a summary of the surgical strategies and fixation techniques tailored to the varying complexities of Letenneur type II fractures, ensuring that listeners appreciate both the nuanced approaches required for different fracture types and the critical aspect of maintaining anatomical alignment for optimal patient outcomes.

Specialties