medial femoral condyle fracture treatmentmedial femoral condyle fracture treatment

Hoppenfeld S, Murthy VL. Discussion: This could also be described as chondromalacia which is basically a kind term for arthritis. 48 (12): 1961-1974. 2009. 7 Subchondral fractures also occur in the lateral femoral condyle or tibial plateau. North Am. Mears SC, McCarthy EF, Jones LC et-al. 1995 Jul-Aug. 15 (4):444-8. Malunion can result in loss of motion or angulation. 16 (2):117-23. -, Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. Surgical intervention may be recommended as a method of treatment whether that be the insertion of pins to stabilise the joint, to a complete knee replacement. sharing sensitive information, make sure youre on a federal subchondral stress/fatigue fracture: overuse injuries in patients without associated risk factors 17. [QxMD MEDLINE Link]. 2002 Nov;31(11):615-23. doi: 10.1007/s00256-002-0575-z. In case of vertical fracture lines, screw fixation and buttress plates are necessary to achieve stability. 2006 Dec;41(12):751-4. It is important to recognize that with a chondroplasty one does not cure a cartilage problem and is mainly dealing with a mechanical irritation due to the rough cartilage edges. 2006;37:691697. Curr Opin Pediatr. government site. Gorbachova T, Amber I, Beckmann NM, Bennett DL, Chang EY, Davis L, Gonzalez FM, Hansford BG, Howe BM, Lenchik L, Winalski CS, Bredella MA. Orthop. Sunday: 9am - 4pm. The patient complained of severe pain in the right knee and could not move her knee. Oh CW, Park BC, Ihn JC, Kyung HS. Acad. 2000;82 (6): 858-66. Concurrent injury to the radial head may result in decreased motion. lt=""-/W3C/DTD XHTML 1.0 Strict/EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-s" title=""-/W3C/DTD XHTML 1.0 Strict/EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-s">. Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort. Recognizing that spontaneous osteonecrosis of the knee was a misnomer and actually represents a subchondral insufficiency fracture that progressed to subchondral collapse with secondary osteonecrosis,the Society of Skeletal Radiology Subchondral Bone Nomenclature Committee recommended that "subchondral insufficiency fracture" be the preferred term 17. If one fits all of these criteria, or one can be treated with surgery to correct these criteria, then one could be a candidate for a cartilage resurfacing procedure. V. Distal humerus. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Murali Poduval, MBBS, MS, DNB is a member of the following medical societies: Association of Medical Consultants of Mumbai, Bombay Orthopedic Society, Indian Orthopedic Association, Indian Society of Hip and Knee SurgeonsDisclosure: Nothing to disclose. The anterior aspect of the distal femur (trochlea) meets the patella to form the patellofemoral articulation. As it is a high-energy injury it will often be seen with other injuries of the knee. Zhou W, Yu J, Wang S, Zhang L, Li L. Use of MRI assisting the diagnosis of pediatric medial condyle fractures of the distal humerus. The fracture surfaces are identified and cleaned, and the joint space is cleaned and irrigated to remove loose particles. and transmitted securely. Ergin N, Demirel M, entrk F, Bayram S, Bilgili F. Long-term comparative study of internal fixation with Kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus in children: A 10-year follow-up of 42 cases. They are covered by articular cartilage and function as a shock absorber for the knee. 2010 Apr. [QxMD MEDLINE Link]. Editorially reviewed, not externally peer-reviewed. The ulnar nerve must be identified and protected; ulnar nerve transposition is usually unnecessary. Supracondyle wedge osteotomy has been advocated to restore anatomic angulation and motion loss from previous injury. ADVERTISEMENT: Supporters see fewer/no ads. The patient had an uneventful postoperative recovery. Gwathmey F.W., Jr., Jones-Quaidoo S.M., Kahler D., Hurwitz S., Cui Q. Distal femoral fractures: current concepts. Skeletal Radiol. Murphy C.G., Chrea B., Molloy A.P., Nicholson P. Small is challenging; distal femur fracture management in an elderly lady with achondroplastic dwarfism. 130 (5):649-55. Report of two cases. Her vital signs were normal. Shillington M, Collins B, Walsh HP. Fractures and other serious injuries to the knee can result in damage to nearby nerves, blood vessels and other musculoskeletal structures, causing chronic pain or permanent injury. For more information on femoral condyle conditions and the available treatment options for your knee pain, please contact the offices of Dr. Robert LaPrade, serving patients from the Twin Cities, Minneapolis-St. Paul, Edina and Eagan, MN. Received 2020 Feb 17; Revised 2020 Apr 20; Accepted 2020 Apr 20. Olecranon acting as a wedge and creating medial condyle fracture. An official website of the United States government. The authors concluded that favorable clinical and radiologic outcomes at long-term follow-up may be achievable by using two smooth K-wires for younger children and screw fixation for children near skeletal maturity. Nonunion J Orthop Traumatol. encoded search term (Medial Humeral Condyle Fracture) and Medial Humeral Condyle Fracture. Ngom G, Fall I, Sy MH, Dieme C, Ndoye M. [Fractures of the medial humeral epicondyle in child: preliminary study about 18 cases]. Active ROM with physical therapist supervision is critical to prevent excess loss of flexion and extension. Ghawabi MH. Two days after injury, we performed open reduction and internal fixation using locking compression plate for proximal tibia and screws. Narvez JA, Narvez J, De Lama E et-al. 1987 Jul-Aug. 7 (4):421-3. 2007 Aug. 15 (2):170-3. You can visit our FAQs for more information about appointments at Vitalis Physiotherapy. J Orthop Trauma. Christian Medical and Dental Associations, Association of Medical Consultants of Mumbai. Bethesda, MD 20894, Web Policies Fractures of the femur are more commonly at the top, at the neck of the femur, or in the main shaft. Medial condyle fractures of the humerus in children. Radiography must be repeated until the union is ensured. More profound ulnar nerve dysfunction has been observed to occur with manipulative reduction attempts, especially if closed manipulation of an incarcerated fragment is attempted. The https:// ensures that you are connecting to the FOIA Apply a sterile. 2). Cartil. The entity subsumes that previously known as spontaneous osteonecrosis of the knee (SONK/SPONK) or Ahlbck disease. Mirsky EC, Karas EH, Weiner LS. The femur is the longest bone in the body. IS attended the surgery, and all authors read this paper. The site is secure. J Orthop Trauma. The .gov means its official. 3). To our knowledge there have been no previous reports of stress fractures of the medial femoral condyle. Pappas N, Lawrence JT, Donegan D, Ganley T, Flynn JM. By definition,secondary osteonecrosis of the knee occurs secondary to an insult. [QxMD MEDLINE Link]. Jegan Krishnan, MBBS, FRACS, PhD Professor, Chair, Department of Orthopedic Surgery, Flinders University of South Australia; Senior Clinical Director of Orthopedic Surgery, Repatriation General Hospital; Private Practice, Orthopaedics SA, Flinders Private Hospital 2001 Sep. 83 (9):1299-305. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. 1990. [QxMD MEDLINE Link]. Arch Orthop Trauma Surg. Accessibility Chacha PB. Fracture of the medial condyle of the humerus. Ann R Coll Surg Engl. Impaction Fracture of the Medial Femoral Condyle assessment of the anterior cruciate liga-ment with the anterior drawer and Lach-man tests was negative for laxity. 1986 Aug. 57 (4):309-12. Displaced medial epicondyle fractures of the humerus: surgical treatment and results. Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands. Long-term functional assessment has demonstrated similar results even with radiographic nonunion being apparent on most of the fractures treated nonoperatively. 2022 May;56(3):228-231. doi: 10.5152/j.aott.2022.21325. The .gov means its official. Federal government websites often end in .gov or .mil. NCI CPTC Antibody Characterization Program, Court-Brown C.M., Caesar B. Res. Please let our friendly reception staff know the background and severity of your condition. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Bookshelf Skeletal Radiol. At the time the article was created Frank Gaillard had no recorded disclosures. 2009;114 (3): 437-47. 11 (2):117-20. 1987 Jan-Feb. 7 (1):54-60. Please enable it to take advantage of the complete set of features! Keywords: Surgical treatment and rehabilitation of medial Hoffa fracture fixed by locking plate and additional screws: A retrospective cohort study. Anteroposterior view after fixation. In this lateral view, fragment is marked with circle. Dependant on the injury the fracture may be close, meaning the skin is not broken or, open where the bone protrudes through the skin. American journal of roentgenology. When the cartilage defect is more localized, surgery may be indicated. FOIA Most avulsion fractures heal very well without surgical intervention. Catgut suture as a means of internal fixation has proved to be inadequate, in that it has often resulted in this complication. The presence of blood and glistening fat globules indicates lipohemarthrosis, which is pathognomonic for intraarticular knee fracture.</p> <p>Document the neurovascular status. 2010 May. The https:// ensures that you are connecting to the Zywiel MG, Mcgrath MS, Seyler TM et-al. We report a case of patellar dislocation with OCF in the weight-bearing area of LFC. At Vitalis Physiotherapy, we tailor a unique treatment plan to aid in your recovery through: Your physiotherapist may also advise heat or ice application, rest and if necessary, pain medication. As a library, NLM provides access to scientific literature. The tibiofemoral joint is the largest weight-bearing joint in the body and takes large force when the joint is used in activities such as walking, running, and jumping. [43] The Mayo Elbow Performance Score (MEPS) was used to assess clinical outcomes, in addition to elbow ROM at the last follow-up. Several closed means of reduction can be used, and the success rate with these methods approaches 40%. Babal JC, Mehlman CT, Klein G. Nerve injuries associated with pediatric supracondylar humeral fractures: a meta-analysis. [QxMD MEDLINE Link]. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. 1964 Sep. 4:592-607. PMC One presumed mechanism of injury is a Stieda fracture (avulsion injury of the medial collateral ligament at the medial femoral condyle). The blood supply to the epiphysis is through the soft-tissue attachments at the medial epicondyle. MeSH Int. Materials and methods Rev Rhum Engl Ed. J Bone Joint Surg Am. 6. He offers Online Physiotherapy Appointments. Subchondral hypointense fracture lines tend to resolve with conservative therapy. Inclusion in an NLM database does not imply endorsement of, or agreement with, Dr. Robert F. LaPrade operated on my right knee in May of 2010. There has been disagreement regarding how to manage a fracture that has remained untreated for several weeks or longer. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. J Bone Joint Surg Am. 2013;21 (2): 340-5. Philadelphia: Lippincott Williams & Wilkins; 2000. We used a locking compression plate - proximal tibial plate 4.5/5.0 (Depuy Synthes TRAUMA) as a buttress plate. Microsurgery. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. John J Walsh, IV, MD Professor and Chairman, Department of Orthopedic Surgery, University of South Carolina School of Medicine MILCH H. FRACTURES AND FRACTURE DISLOCATIONS OF THE HUMERAL CONDYLES. Radiol Med. 1982 Jan. 7 (4):239-49. The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7%, 53/70) and ipsilateral meniscal injury (94.1%, 64/68) were frequently associated. 2020 Jan. 26 (1):137-143. Clin. Narvez JA, Narvez J, De Lama E, Snchez A. Eur Radiol. You will likely be referred for CT, X-ray or MRI scans to determine the extent of the injury. Joseph P Rectenwald, MD Orthopaedic Associates of Augusta, PA Harrison RB, Keats TE, Frankel CJ, Anderson RL, Youngblood P. Radiographic clues to fractures of the unossified medial humeral condyle in young children. Curr Opin Pediatr. The sagital plane is a vertical plane that runs from front to back and decides the body from side to side. A posterior splint is then applied for at least 7-10 days until ROM is initiated. Fahey JJ, O'Brien ET. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Acta Orthop. The goals of treatment include restoration of function and esthetics. He offers. [37, 38] and open fracture are indications for operative management. The .gov means its official. [QxMD MEDLINE Link]. Nondisplaced medial condyle fractures can be treated without surgery. Federal government websites often end in .gov or .mil. At the latest follow-up, the patient achieved a range of motion of 0 to 120 and could walk without pain. 2010;29: 38-42. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). [QxMD MEDLINE Link]. Epub 2012 Aug 2. Tarallo L, Mugnai R, Fiacchi F, Adani R, Zambianchi F, Catani F. Pediatric medial epicondyle fractures with intra-articular elbow incarceration. It accounts for only about 5% of fracture to the femur, and that is less than 0.5% of all fractures. 2020 Nov-Dec;11(6):1072-1081. doi: 10.1016/j.jcot.2020.10.013. Penny P, Swords M, Heisler J, Cien A, Sands A, Cole P. Injury. Anteroposterior view of displaced medial epicondyle fracture after reduction. The implant fitted well and enhanced joint stability. Larger cartilage defects are best treated by more advanced surgeries, which often involve replacing all of the cartilage surface or the bony cartilage surface. 31 (3):331-3. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. 2007;14 (2): 112-6. A radiographic nonunion of the medial epicondyle fracture fragment associated with nonsurgical treatment was not found to have any functional impairment in at least one long-term study. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. Ability of modern distal tibia plates to stabilize comminuted pilon fracture fragments: Is dual plate fixation necessary? If the epicondyle is fragmented, excision of the fragment and fixation of the flexor-pronator origin and medial collateral ligament (MCL) to bone with an alternative form of fixation (eg, suture anchors) may be used. official website and that any information you provide is encrypted The plate fit the bone surface well, despite some bending, the clinical and radiological outcomes were good. Restoration, stability, and postoperative radiographs were acceptable (Fig. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. 2008;90 (3): 324-9. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Introduction: J Bone Joint Surg Am. Vascularized medial femoral condyle corticoperiosteal flaps for the treatment of recalcitrant humeral nonunions. Treatment Bone marrow edema (BME) is when normal fatty bone marrow the spongy tissue in the center of bonesis replaced with a watery mix of fluid and blood. Case presentation [39] Other controversial relative surgical indications include complete ulnar nerve dysfunction after an injury or reduction attempt and valgus instability in high-demand athletes. Treatment of cartilage defects of the femoral condyles requires a thorough workup and ensuring that the defects are truly symptomatic. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. Patients with knee fractures may have a history of the following: Patella fracture - Caused by a direct blow, such as a dashboard injury in a motor vehicle accident or a fall on a flexed knee, also caused by forceful quadriceps contraction while the knee is in the semiflexed position (eg, in a stumble or fall). Fracture of the medial condyle of the humerus in children: a report of 4 cases including the late sequelae. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . We have immediate appointments available today. Please enable it to take advantage of the complete set of features! We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. Epub 2002 Sep 21. This is called the cartilage margin shoulder. Oper Orthop Traumatol. Clin. Some have suggested conservative treatment for fractures older than 4 weeks, whereas others have demonstrated some restored function in treating these fractures at the time of delayed diagnosis, though the results are imperfect. Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A., Orgill D.P., For the SCARE Group The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines. Federal government websites often end in .gov or .mil. Conclusion: The femoral condyles are located on the end of the thigh bone, or the femur. Patient underwent TTR at 5 months postoperatively. 1990;154 (2): 331-6. These fractures are called high-energy injuries due to the high forces needed to cause a break in this strong bone. She did not present loss of consciousness, central nervous system dysfunction, or paralysis. 2014;100:873877. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. J. Surg. Leet AI, Young C, Hoffer MM. In the later stages features seen include: complicating subchondral fracture with periosteal reaction, On radiographs the Koshino classificiation is sometimes used which is as 18, stage II: radiolucency in subchondral weight-bearing area, stage III: expanded lucent area surrounded by sclerosis, subchondral bone collapse, stage IV: osteophytes and osteosclerosis on affected condyle. 2013. Lateral view after reduction. Fowles JV, Kassab MT. Partial or complete recovery may take months. 28 (2):2309499020921755. J Orthop Surg (Hong Kong). Etiology of temporomandibular joint ankylosis secondary to condylar fractures: the role of concomitant mandibular fractures. Heterotopic ossification can result in severe loss of flexion and extension. The patient shared her perspective on the treatment when her wound was healed completely. McDonald T.C., Lambert J.J., Hulick R.M., Graves M.L., Russell G.V., Spitler C.A. Bethesda, MD 20894, Web Policies A median nerve injury may occur as well; however, this is more common with an associated elbow dislocation. Most of the other complications associated with medial epicondyle fractures are considered minor and do not result in a loss of function. Femoral condyle fractures due to . 81 (2):224-7. Medial condyle fracture caused by traction through flexor pronator origin. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 11 (3):209-12. Bookshelf Careers. The site is secure. Epub 2013 Sep 7. Immediate treatment will need to be at the emergency room. These minor complications include radiographic nonunion of the medial epicondyle fragment in cases in which the fracture is treated closed. [QxMD MEDLINE Link]. Case report; Femoral medial condyle fracture; Knee; Proximal tibial plate; Surgery. 17. Philadelphia: Wolters Kluwer; 2018. This generalized information is a limited summary of diagnosis, treatment, and/or medication information. Epidemiology of adult fractures: a review. Please enable it to take advantage of the complete set of features! 1965 Jul-Aug. 41:43-50. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. 2004 May;33(5):260-4. doi: 10.1007/s00256-004-0751-4. This immobilization must be balanced against the need for physical therapy to prevent loss of ROM. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. It articulates with the shin bone to make the tibiofemoral joint, which is better known as the knee. Intraobserver and interobserver agreement in the measurement of displaced humeral medial epicondyle fractures in children. Citation, DOI, disclosures and article data. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Weerakkody Y, Bickle I, et al. Epub 2015 May 26. Then, we placed the proximal tibia plate (Depuy Synthes: LCP proximal tibial plate 4.5) upside down (Fig. Subchondral impaction fractures of the non-weight-bearing portion of the lateral femoral condyle. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. Institutional review board approval was not required because all data were collected from clinical records and imaging systems for routine preoperative planning and follow-up. A valgus deformity also can result from imperfect restoration of position. Am. 4 (1):98-101. 2021;40(5):443-57. Bjrkengren AG, Alrowaih A, Lindstrand A et-al. [QxMD MEDLINE Link]. 1986 Jul-Aug. 6 (4):430-3. Elbow stability and ROM are assessed. J. The weight bearing protocol was: touch gait for first 4 weeks, 1/4 partial weight bearing (PWB) for weeks 46, 1/2 PWB for weeks 68, 3/4 PWB for weeks 810, and full weight bearing. Functionally, no limitation from this radiographic finding appears to exist. Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare [[1], [2], [3]], caused by a direct impact on the flexed knee during weight bearing [3]. MeSH All six patients were women and four were older than 75 years. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI. Unable to load your collection due to an error, Unable to load your delegates due to an error. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. 91 (2):W12-4. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. Any damage to the cartilage in the body in effect is arthritis. J Orthop Trauma. Treatment and Rehabilitation of Fractures. Glotzbecker M. Distal humeral physeal, medial condyle, lateral epicondylar, and other uncommon elbow fractures. 8. Further treatment of these fractures varies dependant on the specifics of the fracture and the other injuries that my have occurred to the surrounding tissues, as well as the individuals health and fitness. Recurrent bilateral insufficiency fracture of the talus. If the patient is unable to tolerate a long surgical procedure because of polytrauma, closed reduction and cast immobilization with 90 of flexion is an option. -, Gwathmey F.W., Jr., Jones-Quaidoo S.M., Kahler D., Hurwitz S., Cui Q. Distal femoral fractures: current concepts. HHS Vulnerability Disclosure, Help Atlas Oral Maxillofac Surg Clin North Am. Yates PJ, Calder JD, Stranks GJ et-al. 4010 W. 65th St. -, Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A., Orgill D.P., For the SCARE Group The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines. Bone density was subnormal in five of the six patients. Edmonds EW. Surgery is the gold standard for displaced fractures or to enable rapid return of knee function. Physical therapy is also highly beneficial in rehabilitating the structures around the knee after a fracture to increase range of movement and strength. [44] with a thickening deformity at the fracture site can occur with inadequate reduction, fixation, or immobilization. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Thank you for choosing Dr. LaPrade as your healthcare provider. Contact Vitalis Physiotherapy now to book in your treatment. Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Louahem DM, Bourelle S, Buscayret F, Mazeau P, Kelly P, Dimeglio A, et al. As with nonunion, this can result from inadequate fixation or premature mobilization. Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. In one case, 40 of varus angulation was reported that went untreated for 4 years. Pronation and supination are usually not affected. J Pediatr Orthop. Salter-Harris type IV medial condyle fractures with 2 mm or more of displacement usually must be treated by means of open reduction with internal fixation (ORIF). This is the first report on a fracture of medial femoral condyle treated with this implant. These fractures account for approximately 40% of all femoral condylar fracture injuries. Similar functional results have been reported with operative and nonoperative surgical management. An official website of the United States government. In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. This may be indicated in smaller lesions in patients who may not be candidates for more advanced cartilage treatment to help deal with the mechanical symptoms. Without adequate nourishment, the affected portion of bone dies and gradually collapses. Fracture of the medical condyle of the humerus with rotational displacement. Are you recovering from a fractured femoral condyle? Primary osteonecrosis of the femoral condyle shares several features with insufficiency fractures, including predominance in elderly women with factors responsible for mechanical stress (varum, obesity, trivial trauma), mechanical pain, and increased radionuclide uptake. Epub 2002 Dec 19. Proximal tibia plate (Depuy Synthes: LCP proximal tibial plate 4.5) was placed upside down and fixed with cortical and locking screws. Management of nonunion of humeral medial condyle fracture: A case series and review of the literature. 8600 Rockville Pike Rockwood and Wilkins' Fractures in Children. The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture. At the time the article was last revised Yuranga Weerakkody had It was first systematically described by Ahlbck in 1968 2. First, if there are rather large amounts of arthritis with cartilage thinning, a program of physical therapy to work on strengthening of the muscles so one has better absorption and puts less stress across the knee, can be indicated. Median MEPS scores were 95 in group A and 94 in group B. This paper reports just the record of patient treatment. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Salter-Harris type III fracture of the medial femoral condyle associated with an . Intraoperative femoral condyle fracture is a significant but rarely reported complication during primary total knee arthroplasty (TKA). [Full Text]. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating unit and growth center, must be taken into account for the successful management of these injuries. This type of surgery is considered the gold standard because the cartilage has an excellent chance of healing and if one follows a proper rehabilitation program with low impact activities only for the first year after implantation, there are excellent outcomes described in the literature for this procedure. 1996 Dec;63(11):859-61. high energy with significant displacement, low energy, often fall from standing, in osteoporotic bone, usually with lesser degree of displacement, medial condyle extends more distal than lateral, posterior halves of both condyles are posterior to the posterior cortex of femoral shaft, direction of deformity is dependent on the location of comminution and the relation of fracture lines to the adductor tubercle, extension at the fracture site (apex posterior), rotation of condyles when an intercondylar split is present, portion of the articular surface remains in continuity with shaft, 33B3 is in the coronal plane (Hoffa fragment), articular fragment separated from the shaft, pain of distal femur that is made worse with knee movement, knee effusion may be present with intraarticular involvement, evaluate for wounds concerning for an open fracture, <0.9 = 97% specific and 95% sensitive for major arterial injury, AP, lateral, and oblique traction views can help characterize injury but are painful for the patient, obtain imaging of entire femur to rule out associated injuries, consider views of the contralateral femur for pre-operative planning and templating, can be difficult to visualize intraarticular extension, condyles are malrotated in sagittal plane with respects to each other, sagittal intra-articular splut is most common, intra-articular distal femoral fracture in the coronal plane, after external fixation to assess pattern, comminution, and intraarticular extension, separate osteochondral fragments in the area of the intercondylar notch, i.e., hard and soft signs (pulselessness, rapidly expanding hematoma, massive bleeding, etc.