medial femoral condyle fracture treatment
Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. Closed reduction with cast immobilization is adequate for nondisplaced stable medial condyle fractures. 1975 Jul. We recommend a consultation with a medical professional such as James McCormack. Go to: Consultations A 80-year-old woman fell down 15 steps at her home and reported to our hospital with severe right knee pain. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 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. Passive ROM should be avoided because it can result in damage to contracted soft tissues and has been associated with myositis ossificans. -, 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. Accessibility Each leg has two condyles, one medial (to the inner side of the knee) and one lateral (to the outer side of the knee). Subchondral hypointense fracture lines tend to resolve with conservative therapy. 2004;35 (3): 293-303, viii. A valgus deformity also can result from imperfect restoration of position. [QxMD MEDLINE Link]. Management of nonunion of humeral medial condyle fracture: A case series and review of the literature. Sunday: 9am - 4pm. 2021;40(5):443-57. Anteroposterior view of displaced medial epicondyle fracture after reduction. Femoral Condyle Cartilage Defect Treatment: Treatment of cartilage defects of the femoral condyles requires a thorough workup and ensuring that the defects are truly symptomatic. 2016 Aug;47(8):1761-9. doi: 10.1016/j.injury.2016.05.026. See this image and copyright information in PMC. 2014 Jul 26. Protective splinting may be continued for 3 weeks if necessary. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. J Bone Joint Surg Am. 2013 Feb;42(2):177-85. doi: 10.1007/s00256-012-1492-4. North Am. Similar functional results have been reported with operative and nonoperative surgical management. Medial humeral epicondylar fracture in children and adolescents. Received 2020 Feb 17; Revised 2020 Apr 20; Accepted 2020 Apr 20. 2015 Jun. 2006;37:691697. To date, however, no consensus exists regarding the optimal implant due to few cases [2]. It is almost always unilateral, usually affects the medial femoral condyle (but can occasionally involve the tibial plateau 9) and is often associated with a meniscal tear. At the time the article was created Frank Gaillard had no recorded disclosures. Typically these injuries are related to a fall from a height or a road traffic incident. All you need to do is just give us a call on 0410 559 856 and request an initial appointment. 3 (4):352-4. Narvez JA, Narvez J, De Lama E et-al. On examination, bruising and tenderness were present on her head, back, right hip, right knee, and left shoulder. An official website of the United States government. Dellon AL, Ducic I, Dejesus RA. Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. Here, we report a case of femoral medial condyle fracture treated with lag screws and proximal tibial plate as a buttress plate. [QxMD MEDLINE Link]. Careers, Unable to load your collection due to an error. This mean that a Hoffa fracture will be seen on X-ray or MRI from a side view. The femur is the longest bone in the body. Fractures of the mandibular condyle: evidence base and current concepts of management. -. Medscape Education. It was first systematically described by Ahlbck in 1968 2. Features can vary depending on the stage and are best characterized on T2-weighted and proton density-weighted sequences. Although subchondral impaction fractures have already been reported in the non-weight-bearing portion of the lateral femoral condyle, this study reveals the presence of an intra-articular impaction fracture of the postero-superior region of the non-weight-bearing portion of the medial femoral condyle recognized in 5 of a group of . She did not present loss of consciousness, central nervous system dysfunction, or paralysis. Bethesda, MD 20894, Web Policies Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee. [QxMD MEDLINE Link]. This answers all my questions! [QxMD MEDLINE Link]. Joseph P Rectenwald, MD Orthopaedic Associates of Augusta, PA 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. Roemer FW, Frobell R, Hunter DJ et-al. Heterotopic ossification can result in severe loss of flexion and extension. 1986 Jul-Aug. 6 (4):430-3. [QxMD MEDLINE Link]. 81 (2):224-7. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. Surgery is the gold standard for displaced fractures or to enable rapid return of knee function. Plain radiography and computed tomography. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. There are two femoral condyles. 2012 Jun. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. 2020 Jan. 26 (1):137-143. 2004;35 (3): 365-70, x. Disclaimer. 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. 10 (2):e0438. 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. These fractures are called high-energy injuries due to the high forces needed to cause a break in this strong bone. John J Walsh, IV, MD Professor and Chairman, Department of Orthopedic Surgery, University of South Carolina School of Medicine encoded search term (Medial Humeral Condyle Fracture) and Medial Humeral Condyle Fracture. MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. Epidemiology of adult fractures: a review. 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. History Mystery: Did Subdural Hematoma Kill Thomas Aquinas? Acute nontraumatic adult knee pain: the role of MR imaging. -, Ehlinger M., Ducrot G., Adam P., Bonnomet F. Distal femur fractures. One presumed mechanism of injury is a Stieda fracture (avulsion injury of the medial collateral ligament at the medial femoral condyle). 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">. 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 . [Full Text]. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2010;29: 38-42. Femoral medial condyle fracture is a rare fracture. 1990. Femoral medial condyle fracture is a rare fracture. If the fragment is incarcerated in the joint, the incidence of ulnar nerve dysfunction can reach 50%. Cartilage damage can be treated in many different ways. Skeletal Radiol. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Are you sure you want to trigger topic in your Anconeus AI algorithm? Here, we present a case with femoral medial condyle fracture treated with a proximal tibial plate. Some minor loss of motion (flexion and extension) is a common sequela of many displaced medial condyle fractures. Subchondral insufficiency fracture of the femoral head. sharing sensitive information, make sure youre on a federal At the latest follow-up, the patient achieved a range of motion of 0 to 120 and could walk without pain. J Pediatr Orthop. 11 (2):117-20. 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. Behrman MJ, Shelton ML. The sagital plane is a vertical plane that runs from front to back and decides the body from side to side. We used a proximal tibial plate upside down as a buttress plate for femoral medial condyle fracture. Gwathmey F.W., Jr., Jones-Quaidoo S.M., Kahler D., Hurwitz S., Cui Q. Distal femoral fractures: current concepts. J Bone Joint Surg Am. 2000 Mar-Apr. Injury to the ulnar nerve may result in a partial clawhand, muscle weakness, and partial loss of sensation. 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. official website and that any information you provide is encrypted Federal government websites often end in .gov or .mil. Skeletal Radiol. The major controversy involving medial epicondyle fractures has involved the management of displaced fractures. 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]. Concurrent injury to the radial head may result in decreased motion. [QxMD MEDLINE Link]. How displaced are "nondisplaced" fractures of the medial humeral epicondyle in children? The proximal tibial plate could become the method of choice for such fractures. The medial and lateral condyles of the femur rest on the tibial plateau to form the tibiofemoral articulation. An epidemiological analysis of 589 cases. Cartil. The femoral condyles are the lower part of the femur where the shaft widens to two condyles, one medial and one lateral. MeSH The entity subsumes that previously known as spontaneous osteonecrosis of the knee (SONK/SPONK) or Ahlbck disease. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. A longitudinal incision is made over the medial supracondyle ridge of the humerus and continued just distal to the medial condyle. 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. In this procedure, the bone and cartilage units are replaced by somebody who has recently died (an allograft), and replacing the whole bone and cartilage unit. [QxMD MEDLINE Link]. 2007 Aug. 15 (2):170-3. To the best of our knowledge, no case reports exist of this fracture treated with a proximal tibial plate. [44] with a thickening deformity at the fracture site can occur with inadequate reduction, fixation, or immobilization. [20, 21, 40, 31, 42]. 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. 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. The patient's treatment plan included 6 weeks of weight The implant fitted well and enhanced joint stability. The plate was bent to fit the bone surface and fixed with cortical and locking screws. The patient shared her perspective on the treatment when her wound was healed completely. 2010 Feb. 92 (2):322-7. Functionally, no limitation from this radiographic finding appears to exist. Mechanical Evaluation of Titanium Plates for Osteoesynthesis High Neck Condylar Fracture of Mandible. Schematic of two types of medial condyle fractures, as described by Milch. The authors declare that there is no conflict of interests regarding the publication of this paper. The blood supply to the epiphysis is through the soft-tissue attachments at the medial epicondyle. This is not a paper about research work involving human participants. 2003;13 (8): 1843-8. The femoral condyles are located on the end of the thigh bone, or the femur. The https:// ensures that you are connecting to the sharing sensitive information, make sure youre on a federal Subchondral hypointense fracture lines tend to resolve with conservative therapy. 2013;21 (2): 340-5. [Full Text]. Zhonghua Kou Qiang Yi Xue Za Zhi. Saraf SK, Tuli SM. [QxMD MEDLINE Link]. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. Radiography and computed tomography demonstrated a femoral medial condyle fracture of the right knee (Fig. It is important to recognize that one has to be matched to a donor, which means somebody has to die for one to obtain a fresh osteoarticular allograft, and that the basic principles of placement are carefully followed, such as ensuring that the depth of the bone for the fresh allograft are as little as possible, and certainly no more than 1 cm of total bone, or there is a higher risk that the bone will not heal in and ultimately the graft will fail. Jegan Krishnan, MBBS, FRACS, PhD is a member of the following medical societies: Australian Medical Association, Australian Orthopaedic Association, Royal Australasian College of SurgeonsDisclosure: Nothing to disclose. Philadelphia: Wolters Kluwer; 2018. Conclusion: The medial femoral condyle is located on the inside part of the knee whereas the lateral femoral condyle, which is bigger, is located on the outside part of the knee. Spontaneous osteonecrosis of the knee (SONK). Medial epicondyle fractures in children. Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles. 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. Clin Orthop Relat Res. 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. Authors declare there are no funding resources for this paper.
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