Complex Variant of Paediatric Conjoint Bicondylar Hoffa Fracture: A Rare Entity

Isolated, closed, conjoint bicondylar Hoffa fracture in a child is extremely rare with only three cases reported in literature till date. We report a complex variant of this very rare injury. An 11-year-old male child reported 2-week post-trauma with history of fall from a tree and injury to his right knee. Radiographs revealed a coronal plane fracture of the distal femur. The patient was operated using the swashbuckler approach, which revealed a sagittal split of the lateral femoral condyle along with a conjoint bicondylar Hoffa fracture. Fixation was done using multiple lag screws and fracture went on to uneventful union. Patient was followed up for 3 years and except for limb shortening of around 1.5 cm secondary to premature physeal closure as a consequence of the injury, he had excellent outcome with full range of motion at the knee, without any deformity.