It is widely accepted among orthopedic surgeons that Hoffa fractures of the femoral condyles occur by a mechanism primarily due to the result of axial force. This type of fracture was first described by Hoffa in 1888 and, thus, named Hoffa fracture ( 2). The Hoffa fracture, a type of coronal fracture of the femoral condyle, is a rare clinical fracture, representing only 0.1% of all fracture types. The most common forms of intra-articular fractures of the knee are distal femoral and tibial plateau fractures, both of which account for more than 80% of all cases ( 1). In addition, our findings pave the way for future research efforts. The orthopedic surgeon may wish to implement these insights into the perioperative algorithm, thereby refining and optimizing clinical patient care. The results indicated that Model B yielded the overall best results in the treatment of Hoffa-like fractures of the tibial plateau. In the internal fixation analysis of the osteoporotic fracture model, we observed patterns similar to the results of the normal bone model. Maximum stress was 1235.6 MPa for Model A, 84.724 MPa for Model B, 99.805 MPa for Model C, and 103.19 MPa for Model D. The maximum displacement in Model C and Model D was comparable, amounting to 0.42345 mm and 0.42273 mm, respectively. The results showed that, in the normal bone model, the maximum displacement of the fracture in Model A was 0.60032 mm, with improved stability through the addition of posterior lateral plate fixation in Model B and reduction of the displacement to 0.38882 mm. The maximum displacement of the model and the maximum stress of the internal fixation material were analyzed by applying an axial load of 2,500 N. The methods compared were lateral L-plate fixation alone (Model A) lateral L-plate combined with posterior anti-slip plate (reconstruction plate/T-plate) fixation (Model B) lateral L-plate combined with posterior hollow nail fixation of the fracture block (Model C) and lateral L-plate combined with anterior hollow nail fixation of the fracture (Model D). In this study, four methods used for internal fixation of Hoffa-like fractures of the tibial plateau were compared using computer simulation and applying a finite element method (FEM). In the field of orthopedics, finite element analysis is considered a valuable method to guide clinical decision-making. This type of fracture, also known as Hoffa-like fracture of the tibial plateau, shares a similar mechanism of injury with the Hoffa fracture of the femoral condyle. 4Pingshan District People’s Hospital of Shenzhen, Pingshan General Hospital of Southern Medical University, Shenzhen, Chinaĭue to the low incidence of posteromedial tibial plateau fractures and limited clinical data available, the optimal treatment for this type of fracture remains to be established.3Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.2Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.1Department of Orthopedics, Jingshan Union Hospital, Union Hospital, Huazhong University of Science and Technology, Wuhan, China.Panayi 2 Leonard Knoedler 3 Bobin Mi 1 Mengfei Liu 1 * Guandong Dai 4 * Guohui Liu 1 * Hang Xue 1 † Junrong Deng 1 † Zhenhe Zhang 1 † Samuel Knoedler 2 Adriana C.
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