48 (12): 1961-1974. Fahey JJ, O'Brien ET. Gwathmey F.W., Jr., Jones-Quaidoo S.M., Kahler D., Hurwitz S., Cui Q. Distal femoral fractures: current concepts. Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles. To date, however, no consensus exists regarding the optimal implant due to few cases [2]. Skeletal Radiol. [QxMD MEDLINE Link]. This includes having an opposing cartilage surface be normal (the medial or lateral tibial plateau), having the shock absorber on that same side be intact or nearly intact (the medial or lateral meniscus), having the weight bearing of the joint not pass into that compartment (not being bowlegged (varus) or knocked knee (valgus)), and ensuring that the ligaments of the knee are intact. Injury. subchondral stress/fatigue fracture: overuse injuries in patients without associated risk factors 17. Closed reduction with cast immobilization is adequate for nondisplaced stable medial condyle fractures. The patient's treatment plan included 6 weeks of weight Some minor loss of motion (flexion and extension) is a common sequela of many displaced medial condyle fractures. [QxMD MEDLINE Link]. Careers, Unable to load your collection due to an error. Gao M, Tao J, Zhou Z, Liu Q, Du L, Shi J. Int J Surg. J Bone Joint Surg Am. Ramnath RR, Kattapuram SV. Prognosis varies from complete recovery to total joint collapse 2. Ability of modern distal tibia plates to stabilize comminuted pilon fracture fragments: Is dual plate fixation necessary? Management of nonunion of humeral medial condyle fracture: A case series and review of the literature. Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review, Femoral Condyle | Articular Cartilage Injury, Effects of a Partial Meniscectomy on Articular Cartilage, FCL Injury or Lateral Collateral Ligament LCL Tear, Lateral Patellar Instability | MPFL Repair, Spontaneous Osteonecrosis of the Knee (SONK), Lateral Patellotibial Ligament Reconstruction, Evaluation of the Patellofemoral Joint Anterior Knee Pain, How to Read an MRI of a Meniscal Root Tear, How to Read an MRI of a Medial Meniscus Tear, How to Read an MRI of a Radial Meniscus Tear, How to Read an MRI of an Osteochondritis Dissecans Lesion, Lateral Meniscus Radial Tear with Separation, 2019 Master Course in Complex Knee Injury by Dr. Robert LaPrade, 2018 Global Cartilage Expert Consensus Meeting, 2018 Vail International Complex Knee Symposium, Dr. LaPrade Discussed Meniscus Repair in AJSM Webinar, Deconstruction to Reconstruction Knee Ligament Reconstruction, Dissection of the Knee: A Comprehensive Layered Analysis, Bioengineering Hip Research: Why its Important to your Practice and Whats Next, Surgical Demo of a Posterolateral Knee Reconstruction, Vail International Complex Knee Symposium, The Menisci: A Comprehensive Review of their Anatomy, Biomechanical Function and Surgical Treatment, Posterolateral Knee Injuries: Anatomy, Evaluation, and Treatment 1st Edition, Live Anatomic Double Bundle PCL Reconstruction. The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture. HHS Vulnerability Disclosure, Help Yates PJ, Calder JD, Stranks GJ et-al. Arthrographic diagnosis of elbow injuries in children. The degree of loss is usually minimal and does not decrease function. [QxMD MEDLINE Link]. The implant fitted well and enhanced joint stability. Medial epicondyle fractures in children. Following this period of healing, knee range of movement will need to be recovered as it will have reduced due to immobility of the joint. The patient was admitted to our hospital for open reduction and internal fixation to be performed the following day. Is Bone Mineral Density Testing Underused in Prostate Cancer Care? Knee. Ngom G, Fall I, Sy MH, Dieme C, Ndoye M. [Fractures of the medial humeral epicondyle in child: preliminary study about 18 cases]. Anteroposterior view of displaced medial epicondyle fracture. for: Medscape. Restoration, stability, and postoperative radiographs were acceptable (Fig. [QxMD MEDLINE Link]. MeSH At the latest follow-up, the patient had a range of motion of 0 to 120 without any pain, could walk freely, and joint surface restoration was maintained radiologically. 1). Ann R Coll Surg Engl. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. However, no currently available anatomical plates fit the femoral medial condyle. At the time the article was last revised Yuranga Weerakkody had 4 (1):98-101. 18. Olecranon acting as a wedge and creating medial condyle fracture. Chacha PB. Glotzbecker M. Distal humeral physeal, medial condyle, lateral epicondylar, and other uncommon elbow fractures. Harrison RB, Keats TE, Frankel CJ, Anderson RL, Youngblood P. Radiographic clues to fractures of the unossified medial humeral condyle in young children. The two main complications associated with medial epicondyle fractures are as follows: The first major complication with an unrecognized medial epicondyle fracture involves loss of motion secondary to impingement of the fragment. [2, 3, 4, 6, 7, 8, 9, 10, 12, 31, 42], A longitudinal incision is made just anterior to the medial epicondyle. The goals of treatment include restoration of function and esthetics. Careers. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. An approximately 5-cm incision centered on the medial femoral condyle was made to expose the femoral attachment of MCL with a careful dissection to the fascia layer. 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. Nevertheless, there are no available anatomical plates that fit either the femoral medial condyle or fracture fixation, except for the relatively short plate developed for distal femoral osteotomy. J Hand Surg Br. -. Dhillon M.S., Mootha A.K., Bali K., Prabhakar S., Dhatt S.S., Kumar V. Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature. The patient had an uneventful postoperative recovery. Excision of the fragment does not appear to yield results comparable to those of nonoperative treatment. Narvez JA, Narvez J, De Lama E et-al. Iowa Orthop J. An epidemiological analysis of 589 cases. Nomenclature of Subchondral Nonneoplastic Bone Lesions. The patient complained of severe pain in the right knee and could not move her knee. 2020 Jan. 26 (1):137-143. The missing piece of the trauma armoury-medial femoral condyle plate. An official website of the United States government. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. 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. This is the first report on a fracture of medial femoral condyle treated with this implant. 3 (4):352-4. 81 (2):224-7. J Pediatr Orthop. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. 9. no financial relationships to ineligible companies to disclose. 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 At the latest follow-up, the patient achieved a range of motion of 0 to 120 and could walk without pain. Osteonecrosis of the knee occurs most often in the medial femoral condyle, a segment of bone located at the lower end of the femur (thighbone). In this lateral view, fragment is marked with circle. [QxMD MEDLINE Link]. -, 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. Murphy C.G., Chrea B., Molloy A.P., Nicholson P. Small is challenging; distal femur fracture management in an elderly lady with achondroplastic dwarfism. Skeletal Radiol. We used a locking compression plate - proximal tibial plate 4.5/5.0 (Depuy Synthes TRAUMA) as a buttress plate. Cartil. Orthop. The site is secure. Oper Orthop Traumatol. 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. An osteochondral detachment from the subchondral bone can be seen (arrow). A smaller defect with good cartilage shoulders can potentially be treated with a microfracture. Roemer FW, Frobell R, Hunter DJ et-al. As it is a high-energy injury it will often be seen with other injuries of the knee. Spontaneous osteonecrosis of the knee: tibial plateaus. There has been disagreement regarding how to manage a fracture that has remained untreated for several weeks or longer. Femoral medial condyle fracture (AO classification 33-B2) is a rare fracture [[1], [2], [3]]. 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. J Orthop Trauma. Medial Humeral Condyle Fracture Treatment & Management - Medscape 7. Elbow dislocation associated with medial epicondyle fracture. Unauthorized use of these marks is strictly prohibited. Gentle active range-of-motion (ROM) exercises may begin within 1 week after injury. Fractures can also be mild (e.g., hairline fracture) or severe (broken into 2 or more fragments, pierced through skin, etc). 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. Philadelphia: Wolters Kluwer; 2018. Any damage to the cartilage in the body in effect is arthritis. [QxMD MEDLINE Link]. 48 (3):199-201. Heterotopic ossification can result in severe loss of flexion and extension. Accessibility Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. 2010;29: 38-42. These are fractures that occur in the coronal plane rather than the more common sagital plane.