Hoffa Fracture – Everything You Need To Know – Dr. Nabil Ebraheim

Apparently there are only 11 of these fractures throughout the world. Click here to read the full story or an excerpt below.



Schoolgirl Atrayee Das is one of five children worldwide to suffer from a rare knee injury that could have crippled her, had a diligent Dubai doctor not diagnosed it.

The 12-year-old was playing at home last month when she tripped and landed awkwardly. Her father Sanjay, who moved his family to Dubai from India six years ago, rushed her to a nearby Lifeline medical clinic.

Because Atrayee could not walk, he worried she had broken her leg. An X-ray showed no clear break or obvious damage and she was sent home to Discovery Gardens. But a day later she was still in pain and her knee had swollen to twice its size, so the family sought a second opinion.

Dr Anand Gorva, a specialist paediatric orthopaedic surgeon, was on shift at Medcare Hospital and checked the X-ray before performing an ultrasound and CT scan. He diagnosed Hoffa’s fracture, where bone fragments are dislodged and get trapped between the cartilage in the knee joint. The injury has been recorded in 11 people worldwide, including five children.

“The fracture is rare in adults but in children it is rarely diagnosed because it is confused with the growing part of the bones in scans,” Dr Gorva said.

“It can look normal but there is actually a fracture. That was the case with Atrayee.”

The cartilage around her knee needed to be fixed in place, otherwise she would not have been able to walk properly. During surgery, Dr Gorva put the bone in the correct anatomical position, inserting screws that did not interfere with the joint.

Had the fracture not been diagnosed, Atrayee could have been permanently disabled because of loss of blood to the joint and swollen cartilage, doctors said.

“Her rehabilitation has been delayed because she can’t take any weight or do strenuous activities for up to six months,” Dr Gorva said. “Overall she is doing well, is happy and can bend her knee 90 degrees. Without the operation, she could have lost the use of her leg and suffered long-term arthritis. The pain is now gone and she will soon be walking well again.”

Her father, a maintenance engineer with Emirates Global Aluminum, was reluctant for his daughter to have an operation but conceded it was the only way for her to lead a normal life.

“She was in a lot of pain but not showing it,” Mr Das said. “The doctor said she has a high threshold for absorbing pain but that it was a serious injury.

“It was the first time she had an operation, so we were all worried. We were told the injury was very rare but the doctors said they could fix the bone with an operation. It was for the best.”

Atrayee has had the plaster cast removed but is still on crutches. Her next challenge is going back to school, into a new class.

“She has missed about three weeks so she has some catching up to do,” her father said.


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