[QxMD MEDLINE Link]. Nondisplaced medial condyle fractures can be treated without surgery. We report a case of patellar dislocation with OCF in the weight-bearing area of LFC. International Journal of Surgery Case Reports. government site. 1997 Feb-Mar. Displaced medial epicondyle fractures of the humerus: surgical treatment and results. Hoffa fracture of the femoral condyle - PMC - National Center for Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. Pellegrini-Stieda lesions are ossified post-traumatic lesions at (or near) the medial femoral collateral ligament adjacent to the margin of the medial femoral condyle. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur. The patient was admitted to our hospital for open reduction and internal fixation to be performed the following day. Misdiagnosis or delay in diagnosis or treatment increases the risk of impairment and complications. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. These minor complications include radiographic nonunion of the medial epicondyle fragment in cases in which the fracture is treated closed. Management of condylar fractures remains a source of ongoing controversy. Symptoms are similar to those of any fracture. Murali Poduval, MBBS, MS, DNB Orthopaedic Surgeon, Senior Consultant, and Subject Matter Expert, Tata Consultancy Services, Mumbai, India Radiography must be repeated until the union is ensured. In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. 2013 Nov;25(4):661-81. doi: 10.1016/j.coms.2013.07.006. Call our friendly team on 0410 559 856. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Ulus Travma Acil Cerrahi Derg. Department of Orthopaedic Surgery, Yaizu City Hospital, Shizuoka, Japan. The https:// ensures that you are connecting to the Materials and methods This is usually related to an overgrowth of the medial condyle. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Accessibility Osteoarthr. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Epub 2018 Jan 17. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). [QxMD MEDLINE Link]. Clin. 8600 Rockville Pike Osteonecrosis of the knee: a review of three disorders. Orthop. 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. Authors declare there are no funding resources for this paper. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Mochizuki Y, Yamamoto N, Noda T, Ozaki T. Acta Orthop Traumatol Turc. 2010 Apr. government site. Femoral medial condyle fracture is a rare fracture. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. 2009;17 (9): 1115-31. Copyright 2020 The Author(s). These lesions may be underdiagnosed since they are easily mistaken for primary osteonecrosis in the absence of magnetic resonance imaging. This may be as early as 3 weeks for nondisplaced fractures and is usually about 6 weeks (occasionally as long as several months) for displaced fractures. Restoration, stability, and postoperative radiographs were acceptable (Fig. There will be a sudden onset of severe pain, and inability to weight bear on that leg. Epub 2002 Sep 21. 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. All six patients were women and four were older than 75 years. Surgical techniques and a review of the literature. Injury. Microsurgery. 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 . 2003;13 (8): 1843-8. Epub 2002 Dec 19. official website and that any information you provide is encrypted Range of motion exercises and mobilized non-weight bearing were started on day one. The implant fitted well and enhanced joint stability. (2019) AJR. 8600 Rockville Pike 2019 Feb. 31 (1):86-91. There has been disagreement regarding how to manage a fracture that has remained untreated for several weeks or longer. Skeletal Radiol. Clipboard, Search History, and several other advanced features are temporarily unavailable. J Pediatr Orthop. -, Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. 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. 2014 Sep. 39 (9):1739-45. John J Walsh, IV, MD Professor and Chairman, Department of Orthopedic Surgery, University of South Carolina School of Medicine Active ROM with physical therapist supervision is critical to prevent excess loss of flexion and extension. 3. Dependant on the injury the fracture may be close, meaning the skin is not broken or, open where the bone protrudes through the skin. [20, 21, 40]. Skeletal Radiol. JBJS Case Connect. Intraoperative femoral condyle fracture is a significant but rarely reported complication during primary total knee arthroplasty (TKA). Swelling can occur and bruising in many cases. Zhonghua Kou Qiang Yi Xue Za Zhi. A loss of elbow extension of 10-15% can be expected in up to 20% of cases, and this appears to be correlated more with prolonged immobilization than the fracture itself. 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. They are covered by articular cartilage and function as a shock absorber for the knee. The site is secure. MeSH Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. Curr Opin Pediatr. Oral Maxillofac Surg. Plain radiography and computed tomography. 2000;82 (6): 858-66. Treatment of cartilage defects of the femoral condyles requires a thorough workup and ensuring that the defects are truly symptomatic. Subchondral insufficiency fracture of the knee is not thought to be caused by bone death but instead by osteoporosis and insufficiency fractures, with histopathologically proven origins in weakened trabeculae and applied microtraumatic forces 6,13. Skeletal Radiol. Accessibility 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. [QxMD MEDLINE Link]. 1970 Oct. 52 (7):1453-8. Medial Humeral Condyle Fracture Treatment & Management - Medscape 2019 Aug. 45 (4):757-761. 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. Subchondral Fractures - Radsource An official website of the United States government. The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture. Physiotherapy is very important during the rehabilitation following a . Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . Hoffa fractures can be of one condyle or can be bicondylar, and are categorised as type 1,2 and 3 depending on the angle of the fracture line, and with letter a,b and c, denoting the region of the femoral condyle that the fracture is in. [QxMD MEDLINE Link]. J. Surg. Cartil. It was first systematically described by Ahlbck in 1968 2. a Photograph obtained during total knee arthroplasty for SIFK in the medial femoral condyle. As a library, NLM provides access to scientific literature. The degree of loss is usually minimal and does not decrease function. Dodds SD, Flanagin BA, Bohl DD, DeLuca PA, Smith BG. 9th ed. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Case presentation: Two days after injury, we performed open reduction and internal fixation using locking compression plate for proximal tibia and screws. 2015 Jul;19:95-102. doi: 10.1016/j.ijsu.2015.05.027. Gao M, Tao J, Zhou Z, Liu Q, Du L, Shi J. Int J Surg. The patient had an uneventful postoperative recovery. Schematic of two types of medial condyle fractures, as described by Milch. J Bone Joint Surg Am. 1964 Sep. 4:592-607. J Orthop Surg (Hong Kong). Protective splinting may be continued for 3 weeks if necessary. J Bone Joint Surg Am. Fractures of the femur are more commonly at the top, at the neck of the femur, or in the main shaft. The goals of treatment include restoration of function and esthetics. Imaging showed failure of the medial femoral condyle to incorporate with talar fragmentation. Therefore, it is important to asses that these cartilage defects are causing symptoms to the patient before embarking on much bigger surgeries because the consequences of having a failed cartilage procedure are often worse than the symptoms that one has prior to having the cartilage surgery performed on a minimally or non-symptomatic knee. Yates C, Sullivan JA. 2007;14 (2): 112-6. 3/58 Oldfield Road, Sinnamon Park Qld 4073, Elbow MCL (Medial Collateral Ligament) Sprain, Stiffness/inability to move the knee joint, Inability/extreme difficulty to weight bear on the knee/leg, Instability feels like the joint is slipping out of place, Stretching, strengthening and/or conditioning exercises. Branches of the medial antebrachial cutaneous nerve should be identified and preserved. 20 (2):173-6. 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">. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Mon - Fri: 8am - 8pm Pronation and supination are usually not affected. 2009. Lateral view after reduction. Conclusion: 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. Ramnath RR, Kattapuram SV. Concomitant medial condyle fracture of the humerus in a childhood posterolateral dislocation of the elbow. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. Fracture separation of the distal humeral epiphysis in children younger than three years old. Papavasiliou V, Nenopoulos S, Venturis T. Fractures of the medial condyle of the humerus in childhood. 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. J Am Acad Orthop Surg. Chap 17. Gorbachova T, Amber I, Beckmann NM, Bennett DL, Chang EY, Davis L, Gonzalez FM, Hansford BG, Howe BM, Lenchik L, Winalski CS, Bredella MA. Strength in the leg will also need to be regained as this will have also reduced with the inactivity. 48 (12): 1961-1974. Informed consent was obtained for the surgery. The https:// ensures that you are connecting to the Bone insufficiency fractures as an inaugural manifestation of primary hyperparathyroidism. Functionally, no limitation from this radiographic finding appears to exist. 2022 Mar;53(3):1237-1240. doi: 10.1016/j.injury.2021.11.034. Fernandez FF, Vatlach S, Wirth T, Eberhardt O. Medial humeral condyle fracture in childhood: a rare but often overlooked injury. Some authors have advocated routine ulnar nerve transposition, whereas others have maintained that this is unnecessary unless the ulnar nerve has been injured. Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. 16. 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.
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