Hoffa fracture associated with ipsilateral femoral shaft fractures is a rare clinical entity. We present a previously unreported multi-trauma case with a unique fracture combination of ipsilateral Hoffa, tibial eminence, femoral shaft and Malgaigne fractures. The Malgaigne fracture was treated non-operatively while the other three fractures were operated with arthroscopic and assisted techniques. Despite the use of minimally invasive techniques, the patient experienced postoperative soft tissue problems. In follow-up, all fractures healed with a good functional outcome. The application of a minimally invasive technique in such a high-energy trauma is crucial for prevention of soft tissue complications.
