medial femoral condyle fracture treatment

For bicondylar fractures, a median parapatellar incision can be used. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: The knee comprises of the thigh bone (femur), the kneecap (patella) and the shin bone (tibia) joining together. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. If you are recovering from fractured femoral condyle, or youre looking for a physiotherapist near me, our physios at Vitalis Physiotherapy can assess your condition to tailor a unique rehabilitation plan to aid in your pain relief and recovery. 1965 Jul-Aug. 41:43-50. A diagnostic pitfall for ankle pain. Careers. Both can sustain an injury and become fractured. 11 (3):209-12. [QxMD MEDLINE Link]. 1984. The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture. Femoral medial condyle fracture (AO classification 33-B2) is a rare fracture [[1], [2], [3]]. sharing sensitive information, make sure youre on a federal Prognosis varies from complete recovery to total joint collapse 2. Subchondral insufficiency fracture of the femoral head. 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. Formation of callus and fibrous tissue may obliterate the fracture site and cause a malunion that makes accurate dissection and reduction less accurate. The femur has another articulation with the patella, called the patellofemoral joint. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Case report; Femoral medial condyle fracture; Knee; Proximal tibial plate; Surgery. We gained access to the joint through the medial parapatellar approach, anatomical restoration of the joint surface was achieved with clamp application. Unable to load your collection due to an error, Unable to load your delegates due to an error. HHS Vulnerability Disclosure, Help 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]. She did not present loss of consciousness, central nervous system dysfunction, or paralysis. However, no currently available anatomical plates fit the femoral medial condyle. Gao M, Tao J, Zhou Z, Liu Q, Du L, Shi J. Int J Surg. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. Reduced fragment is marked. Clin Orthop Relat Res. sharing sensitive information, make sure youre on a federal 2001 Sep. 83 (9):1299-305. Application of mesh plate for the treatment of an osteochondral fracture of the medial femoral condyle with medial wall fracture: A case report. Written informed consent was obtained from the patient for publication of this case report and accompanying images. The fracture surfaces are identified and cleaned, and the joint space is cleaned and irrigated to remove loose particles. Both can sustain an injury and become fractured. Irreducible incarceration of the medial epicondyle fragment Surg. J Am Acad Orthop Surg. If employed, this maneuver is usually performed in the operating room with the patient under general anesthesia. Eur Radiol. A valgus deformity also can result from imperfect restoration of position. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. 1 While BME can occur in any bone, the legs are most often affected. We recommend a consultation with a medical professional such as James McCormack. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzMTI5MC10cmVhdG1lbnQ=, Incarceration of the medial epicondyle fragment within the joint, Failure to recognize incarceration into the joint with functional loss. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). 92 (17):2785-91. Ergin et al, in a long-term (median, 10 years; range, 5-15) comparative study of 42 children with displaced medial epicondyle fractures of the humerus,assessed internal fixation with K-wires (group A; n = 22) vs cannulated screws (group B; n = 20). We report six cases of insufficiency fractures of the medial femoral condyle responsible for severe mechanical pain in the medial knee compartment in the absence of any identifiable precipitating factor. Please let our friendly reception staff know the background and severity of your condition. Federal government websites often end in .gov or .mil. 8600 Rockville Pike Treatment options include loose body removal, microfracture, multiple internal fixation and so on. The patient had an uneventful postoperative recovery. Go to: Consultations {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Weerakkody Y, Bickle I, et al. Int. This paper has been written in line with the SCARE criteria [4]. At the time the article was created Frank Gaillard had no recorded disclosures. Philadelphia: Wolters Kluwer; 2018. PMC These fractures account for approximately 40% of all femoral condylar fracture injuries. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. Before [QxMD MEDLINE Link]. Unable to process the form. Acta Orthop Scand. Treatment and Rehabilitation of Fractures. Clinically Oriented Anatomy. Pathy R, Dodwell ER. Knee Pain Location Chart Muscles of the Knee Hoffa Fat Pad, This is not medical advice. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur. Here, we present a case with femoral medial condyle fracture treated with a proximal tibial plate. Anteroposterior view after fixation. Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. Physiotherapy is very important during the rehabilitation following a . [QxMD MEDLINE Link]. Mochizuki Y, Yamamoto N, Noda T, Ozaki T. Acta Orthop Traumatol Turc. [QxMD MEDLINE Link]. 2010 Oct;48(7):520-6. doi: 10.1016/j.bjoms.2009.10.010. An 80-year-old woman was brought to our hospital with severe right knee pain after falling down 15 steps at her home. Orthop. [QxMD MEDLINE Link]. Shillington M, Collins B, Walsh HP. Sunday: 9am - 4pm. Fowles JV, Kassab MT. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. More controversy exists with displacement of 5-15 mm. Elbow Fractures in Children: Diagnosis and Management. J Orthop Surg (Hong Kong). 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. He offers. Femoral medial condyle fracture is a rare fracture. An incidental finding on MRI scan may not need treatment, and close observation may be indicated in these cases. Two days after the injury, we performed an open reduction and internal fixation using locking compression plate for proximal tibia and lag screws. J Bone Joint Surg Am. Mon - Fri: 8am - 8pm J Pediatr Orthop. Joseph P Rectenwald, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Medical Association of GeorgiaDisclosure: Nothing to disclose. This is called a chondroplasty. 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. 6. 8th ed. Roemer FW, Frobell R, Hunter DJ et-al. Radiography must be repeated until the union is ensured. Treatment of cartilage defects of the femoral condyles requires a thorough workup and ensuring that the defects are truly symptomatic. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. If necessary, transposition of the nerve can be performed to reduce tension and prevent further injury. The post-operative plain radiography and computed tomography. An epidemiological analysis of 589 cases. [QxMD MEDLINE Link]. The patient's treatment plan included 6 weeks of weight bearing as tolerated for the left lower extremity while wearing a knee brace that prevented the final 20 of knee extension, and a program of range-of-motion and progressive resistive exercises, with eventual emphasis on sport-specific activities. Some have advocated operative treatment of high-demand athletes, on the grounds that even minor amounts of valgus instability can result in significant disability. Are you recovering from a fractured femoral condyle? 2020 Apr-Jun. To date, however, no consensus exists regarding the optimal implant due to few cases [2]. Tarallo L, Mugnai R, Fiacchi F, Adani R, Zambianchi F, Catani F. Pediatric medial epicondyle fractures with intra-articular elbow incarceration. The femoral condyles are on the ball-shaped end of the femur which meet at the knee joint. Landin LA, Danielsson LG. 1986 Jul-Aug. 6 (4):430-3. [Posttraumatic temporomandibular joint ankylosis: clinical development and surgical management]. Chap 17. J Pediatr Orthop. Orthop. J Orthop Surg (Hong Kong). An official website of the United States government. 1987 Jan-Feb. 7 (1):54-60. 2018;60:132136. Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A progressive cubitus varus deformity may develop as a consequence of growth inhibition or avascular necrosis (AVN) of the medial humeral condyle. Features can vary depending on the stage and are best characterized on T2-weighted and proton density-weighted sequences. The https:// ensures that you are connecting to the The medial aspect of the knee, and specifically the descending genicular artery (DGA), was first recognized as a potential donor site for a vascularized flap in 1981 [].In 1985, the osteoarticular branch (OAB) of the DGA was realized as a flap supply source in harvesting the adductor magnus tendon and tubercle [].The contemporary medial femoral condyle (MFC) flap was first described in 1988 as . Careers, Unable to load your collection due to an error. 213 (5): 963-982. Patient underwent TTR at 5 months postoperatively. Ulus Travma Acil Cerrahi Derg. A large bone fragment was identified attached to the MCL, of which the MCL is intact. Thus, fractures to this structure are either a medial femoral condyle fracture or a lateral femoral condyle fracture. Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. 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. Myositis ossificans can result from overaggressive physical therapy with passive ROM. HK wrote this paper. Subchondral insufficiency fracture of the knee is seen more frequently in women (M:F 1:3) and affects older patients,typically over the age of 55. J Trauma. 1995 Jul-Aug. 15 (4):444-8. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. The .gov means its official. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. 1990. Each leg has two condyles, one medial (to the inner side of the knee) and one lateral (to the outer side of the knee). FOIA One such maneuver (the Roberts manipulative technique) is performed under sedation and involves placing a valgus stress on the elbow while supinating the forearm and simultaneously dorsiflexing the wrist and fingers to place the forearm flexor muscles on stretch. Bone insufficiency fractures as an inaugural manifestation of primary hyperparathyroidism. In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. We used a proximal tibial plate upside down as a buttress plate for femoral medial condyle fracture. [QxMD MEDLINE Link]. Plain radiography and computed tomography. FOIA Restoration, stability, and postoperative radiographs were acceptable (Fig. The wound is closed, and the arm is splinted in 90 of flexion with the forearm in the neutral position. J Pediatr Orthop. The force of this event may even fracture other bones within the knee or legs. Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension. 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.
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