Christian Medical and Dental Associations, Association of Medical Consultants of Mumbai. 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. HHS Vulnerability Disclosure, Help Citation, DOI, disclosures and article data. Cartilage damage can be treated in many different ways. De Boeck H, De Smet P, Penders W, De Rydt D. Supracondylar elbow fractures with impaction of the medial condyle in children. The wound is closed, and the arm is splinted in 90 of flexion with the forearm in the neutral position. Proximal tibia plate (Depuy Synthes: LCP proximal tibial plate 4.5) was placed upside, The post-operative plain radiography and. Knee Pain Location Chart Muscles of the Knee Hoffa Fat Pad, This is not medical advice. Materials (Basel). [44] with a thickening deformity at the fracture site can occur with inadequate reduction, fixation, or immobilization. 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. Harrison RB, Keats TE, Frankel CJ, Anderson RL, Youngblood P. Radiographic clues to fractures of the unossified medial humeral condyle in young children. The coronal plane a vertical plane that runs from side to side and divides the body from front to back. Written informed consent was obtained from the patient for publication of this case report and accompanying images. Skeletal Radiol. 2009 Mar. 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 ~. Disclaimer. Treatment for most patients is with a rehabilitative course consisting of range-of-motion and stretching exercises of the knee joint and medial collateral ligament. Dodds SD, Flanagin BA, Bohl DD, DeLuca PA, Smith BG. Tarallo L, Mugnai R, Fiacchi F, Adani R, Zambianchi F, Catani F. Pediatric medial epicondyle fractures with intra-articular elbow incarceration. Federal government websites often end in .gov or .mil. At the time the article was last revised Yuranga Weerakkody had Femoral medial condyle fracture is a rare fracture. sharing sensitive information, make sure youre on a federal Treatment of cartilage defects of the femoral condyles requires a thorough workup and ensuring that the defects are truly symptomatic. J Hand Surg Am. Case presentation: Contact us to make an appointment. Although the plate needed bending to achieve congruence, it fit well and yielded a good clinical outcome. Fracture of the medial condyle of the humerus. Surgery is the gold standard for displaced fractures or to enable rapid return of knee function. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. Mirsky EC, Karas EH, Weiner LS. Multiple treatment options are available for both traumatic osteochondral injuries and OCD lesions, with important determining factors of treatment being skeletal maturity of the patient, instability of the fragment . J Bone Joint Surg Am. Orthop. As with nonunion, this can result from inadequate fixation or premature mobilization. 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. 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. The femoral condyles are the lower part of the femur where the shaft widens to two condyles, one medial and one lateral. Microfracture procedures are best indicated for small and well localized defects, commonly those that are 1 cm or less in size and have normal bone surfaces below the defect. 2013. 2004;35 (3): 365-70, x. Malunion can result in loss of motion or angulation. 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. Before Ghawabi MH. The fracture surfaces are identified and cleaned, and the joint space is cleaned and irrigated to remove loose particles. It accounts for only about 5% of fracture to the femur, and that is less than 0.5% of all fractures. Unable to load your collection due to an error, Unable to load your delegates due to an error. 1980 Oct. 62 (7):1159-63. PMC Injury to the ulnar nerve may result in a partial clawhand, muscle weakness, and partial loss of sensation. 2006 Jun. A valgus deformity also can result from imperfect restoration of position. 5. Dependant on the injury the fracture may be close, meaning the skin is not broken or, open where the bone protrudes through the skin. The femur is a long bone that widens at its distal end, these flared parts are called the medial and lateral condyles. The patient's treatment plan included 6 weeks of weight An avulsion fracture occurs when a small chunk of bone attached to a . If you have fractured your femoral condyles, it is important to seek out immediate medical treatment. PMC Therapists must tailor their therapy plan to avoid contracture caused by calcification of the medial collateral ligament. Bethesda, MD 20894, Web Policies Here, we report a case of femoral medial condyle fracture treated with lag screws and proximal tibial plate as a buttress plate. National Library of Medicine Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Case report; Femoral medial condyle fracture; Knee; Proximal tibial plate; Surgery. J Pediatr Orthop. The ulnar nerve is identified and protected and may be transposed anteriorly. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Accessibility 8600 Rockville Pike b-d Histology of subchondral insufficiency fracture (hematoxylin-eosin stain).b The lower surface indicates denuded subarticular bone of the distal femoral condyle, which is caused by secondary osteoarthritic change. Philadelphia: Lippincott Williams & Wilkins; 2000. J. The implant fitted well and enhanced joint stability. 2012 Jun. These fractures are called high-energy injuries due to the high forces needed to cause a break in this strong bone. [QxMD MEDLINE Link]. Res. Most of the other complications associated with medial epicondyle fractures are considered minor and do not result in a loss of function. The site is secure. Prognosis varies from complete recovery to total joint collapse 2. Another type of treatment can involve taking a plug of bone and cartilage, called an osteochondral transfer, from area of the knee and transferring it to the other area of the knee. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Partial or complete recovery may take months. [20, 21, 40]. J Pediatr Orthop. Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. Apply a sterile. Two days after the injury, we performed an open reduction and internal fixation using locking compression plate for proximal tibia and lag screws. In preparation for ORIF, the arm is placed in a posterior splint for stabilization, elevated, and treated with ice packs to decrease swelling. Introduction: We used a proximal tibial plate upside down as a buttress plate for femoral medial condyle fracture. a Photograph obtained during total knee arthroplasty for SIFK in the medial femoral condyle. Louahem DM, Bourelle S, Buscayret F, Mazeau P, Kelly P, Dimeglio A, et al. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Spontaneous osteonecrosis of the knee: tibial plateaus. Oh CW, Park BC, Ihn JC, Kyung HS. North Am. 2. The .gov means its official. FOIA government site. As with any fracture reduction, periosteum and bone fragments are cleared from the fracture site to allow anatomic reduction. Traumatol. 2009;17 (9): 1115-31. The goals of treatment include restoration of function and esthetics. Skeletal Radiol. Ip D, Tsang WL. The https:// ensures that you are connecting to the However, no currently available anatomical plates fit the femoral medial condyle. 8th ed. These surgeries certainly may be indicated in some areas, but the gold standard is still the fresh osteoarticular allograft if possible. Our clinics are open: 1987 Jul-Aug. 7 (4):421-3. Thank you for choosing Dr. LaPrade as your healthcare provider. Department of Orthopaedic Surgery, Yaizu City Hospital, Shizuoka, Japan. However, 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. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Weerakkody Y, Bickle I, et al. The fragment is usually displaced distally and anteriorly. Waters PM, Skaggs DL, Flynn JM, eds. 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. HK wrote this paper. We used a locking compression plate - proximal tibial plate 4.5/5.0 (Depuy Synthes TRAUMA) as a buttress plate. 2011 Oct;42(10):1060-5. doi: 10.1016/j.injury.2011.03.041. Nonunion Epub 2020 Oct 17. [QxMD MEDLINE Link]. Disclaimer. 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. Median MEPS scores were 95 in group A and 94 in group B. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. All you need to do is just give us a call on 0410 559 856 and request an initial appointment. 17. Subchondral hypointense fracture lines tend to resolve with conservative therapy. J Pediatr Orthop. Active ROM with physical therapist supervision is critical to prevent excess loss of flexion and extension. J Bone Joint Surg Am. Robert LaPrade, MD, PhD Epub 2011 May 4. Subchondral insufficiency fracture of the femoral head. Bethesda, MD 20894, Web Policies Accessibility Restoration, stability, and postoperative radiographs were acceptable (Fig. Hoppenfeld S, Murthy VL. Published by Elsevier Ltd.. All rights reserved. Subchondral insufficiency fracture of the knee (SIF/SIFK) are stress fracturesin the femoral condyles or tibial plateau that occur in the absence of acute trauma, typically affecting older adults. [QxMD MEDLINE Link]. Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands. The innervation of the medial humeral epicondyle: implications for medial epicondylar pain. [43] The Mayo Elbow Performance Score (MEPS) was used to assess clinical outcomes, in addition to elbow ROM at the last follow-up. Please enable it to take advantage of the complete set of features! (2019) AJR. 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">. Acta Orthop. 2018 Mar;22(1):91-96. doi: 10.1007/s10006-018-0675-0. Postoperative radiographs confirmed anatomical reduction, and the patient achieved a good result. Unable to load your collection due to an error, Unable to load your delegates due to an error. Fractures can also be mild (e.g., hairline fracture) or severe (broken into 2 or more fragments, pierced through skin, etc). To the best of our knowledge, no case reports exist of this fracture treated with a proximal tibial plate. Manfredini M., Gildone A., Ferrante R., Bernasconi S., Massari L. Unicondylar femoral fractures: therapeutic strategy and long-term results. This type of transfer is also best in small defects It may be used when a microfracture may not be indicated, such as in patients who have bone cysts below a small area of a cartilage defect. 2). -, Ehlinger M., Ducrot G., Adam P., Bonnomet F. Distal femur fractures. 2020 Nov-Dec;11(6):1072-1081. doi: 10.1016/j.jcot.2020.10.013. 8600 Rockville Pike 2010;29: 38-42. [39] Other controversial relative surgical indications include complete ulnar nerve dysfunction after an injury or reduction attempt and valgus instability in high-demand athletes. 1975 Jul. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. Joint distention techniques also have been described to help facilitate closed reduction of the incarcerated medial epicondyle fracture. 1987 Jan-Feb. 7 (1):54-60. Proximal tibia plate (Depuy Synthes: LCP proximal tibial plate 4.5) was placed upside down and fixed with cortical and locking screws. Fernandez FF, Vatlach S, Wirth T, Eberhardt O. Medial humeral condyle fracture in childhood: a rare but often overlooked injury. Unable to load your collection due to an error, Unable to load your delegates due to an error. Elbow stability and ROM are assessed. J Orthop Surg (Hong Kong). AJR Am J Roentgenol. The plate fit the bone surface well, despite some bending, the clinical and radiological outcomes were good. Reduced fragment is marked. Closed reduction with cast immobilization is adequate for nondisplaced stable medial condyle fractures. Because some cases of primary osteonecrosis may be secondary to undiagnosed stress-related microfractures, early diagnosis and elimination of weight bearing are essential. 2019 Aug. 45 (4):757-761. 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. 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. 1971 Sep. 53 (6):1102-4. You can visit our FAQs for more information about appointments at Vitalis Physiotherapy. 9th ed. The patient had an uneventful postoperative recovery. Heterotopic ossification can result in severe loss of flexion and extension. The .gov means its official. Bjrkengren AG, Alrowaih A, Lindstrand A et-al. Injury. The patient was admitted to our hospital for open reduction and internal fixation to be performed the following day. [Posttraumatic temporomandibular joint ankylosis: clinical development and surgical management]. Operative strategy in postero-medial fracture-dislocation of the proximal tibia. Federal government websites often end in .gov or .mil. Fowles JV, Kassab MT. Paediatric medial humeral epicondyle fracture management: 2019 approach. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Fractures of the mandibular condyle: evidence base and current concepts of management. MeSH [QxMD MEDLINE Link]. The diagnosis was established only by magnetic resonance imaging in five cases. The second involves ulnar nerve dysfunction, which may occur in 10-16% of cases. Unauthorized use of these marks is strictly prohibited. 2007;14 (2): 112-6. official website and that any information you provide is encrypted A median nerve injury may occur as well; however, this is more common with an associated elbow dislocation. 2010 May. Wed love to help. 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. and transmitted securely. Two days after injury, we performed open reduction and internal fixation using locking compression plate for proximal tibia and screws. The .gov means its official. [QxMD MEDLINE Link]. This is often associated with delayed fixation and closed head injuries. 2004 May;33(5):260-4. doi: 10.1007/s00256-004-0751-4. Patients often recall an acute onset of severe pain without significant trauma. This immobilization must be balanced against the need for physical therapy to prevent loss of ROM. 11 (2):117-20. Etiology of temporomandibular joint ankylosis secondary to condylar fractures: the role of concomitant mandibular fractures. The degree of loss is usually minimal and does not decrease function. Clipboard, Search History, and several other advanced features are temporarily unavailable. ADVERTISEMENT: Supporters see fewer/no ads. 12. Pappas N, Lawrence JT, Donegan D, Ganley T, Flynn JM. 2003 Aug;13(8):1843-8. doi: 10.1007/s00330-002-1775-6. Medial humeral condyle fracture with an ipsilateral dislocated radial head. These joints are covered by articular cartilage. Orthop. Radiography must be repeated until the union is ensured. sharing sensitive information, make sure youre on a federal Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases. J Bone Joint Surg Br. John J Walsh, IV, MD Professor and Chairman, Department of Orthopedic Surgery, University of South Carolina School of Medicine Epub 2018 Jan 17. for: Medscape. Zieliski R, Kozakiewicz M, Konieczny B, Krasowski M, Okulski J. 16. [QxMD MEDLINE Link]. government site. 2004;35 (3): 293-303, viii. Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns. Anatomical quadrilateral plate for acetabulum fractures involving quadrilateral surface: A review. Orthop. Epub 2021 Nov 18. 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. This generalized information is a limited summary of diagnosis, treatment, and/or medication information. The proximal tibial plate could become the method of choice for such fractures. In case of vertical fracture lines, screw fixation and buttress plates are necessary to achieve stability. Osteonecrosis of the knee: a review of three disorders. JBJS Case Connect. Call our friendly team on 0410 559 856. 10 (2):e0438. Bone density was subnormal in five of the six patients. Careers, Unable to load your collection due to an error. 2013 Nov;25(4):661-81. doi: 10.1016/j.coms.2013.07.006. 57 (5):677-80. LIVIN' ON THE MD EDGE: Drive, Chip, and Putt Your Way to Osteoarthritis Relief, Osteoporosis and Osteopenia: Latest Treatment Recommendations, Osteoporosis: A Bare-Bones Guide to Diagnosis and Treatment. MILCH H. FRACTURES AND FRACTURE DISLOCATIONS OF THE HUMERAL CONDYLES. 1970 Oct. 52 (7):1453-8. 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. Lateral condyle fractures in children: evaluation of classification and treatment. The site is secure. 2008 Jan;66(1):77-84. doi: 10.1016/j.joms.2007.08.013. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. 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. Firth AM, Marson BA, Hunter JB. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-2079, View Frank Gaillard's current disclosures, View Yuranga Weerakkody's current disclosures, see full revision history and disclosures, Spontaneous osteonecrosis of the knee (SONK), Spontaneous osteonecrosis of the knee (SPONK), Spontaneous insufficiency fracture of the knee (SIFK), Subchondral insufficiency fracture of the knee (SIFK). These lesions may be underdiagnosed since they are easily mistaken for primary osteonecrosis in the absence of magnetic resonance imaging. Femoral medial condyle fracture is a rare fracture. Here, we report a case of femoral medial condyle fracture treated with lag screws and proximal tibial plate as a buttress plate. There are two femoral condyles. Babal JC, Mehlman CT, Klein G. Nerve injuries associated with pediatric supracondylar humeral fractures: a meta-analysis. Dellon AL, Ducic I, Dejesus RA. [2, 3, 4, 6, 7, 8, 9, 10, 12, 31, 42], A longitudinal incision is made just anterior to the medial epicondyle. [QxMD MEDLINE Link]. Elbow dislocation associated with medial epicondyle fracture. An official website of the United States government. John J Walsh, IV, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Christian Medical and Dental Associations, American Society for Surgery of the HandDisclosure: Nothing to disclose. [QxMD MEDLINE Link]. Takeda M, Higuchi H, Kimura M et-al. More profound ulnar nerve dysfunction has been observed to occur with manipulative reduction attempts, especially if closed manipulation of an incarcerated fragment is attempted. Haxhija EQ, Mayr JM, Grechenig W, Hllwarth ME. Subchondral hypointense fracture lines tend to resolve with conservative therapy. Suggestive changes were seen on initial roentgenograms in only one case, whereas increased radionuclide uptake was a consistent finding on the bone scan. The ulnar nerve must be identified and protected; ulnar nerve transposition is usually unnecessary. Keywords: Ehlinger M., Ducrot G., Adam P., Bonnomet F. Distal femur fractures. We gained access to the joint through the medial parapatellar approach, anatomical restoration of the joint surface was achieved with clamp application. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Both can sustain an injury and become fractured. Femoral medial condyle fracture (AO classification 33-B2) is a rare fracture [[1], [2], [3]]. Epub 2002 Sep 21. [QxMD MEDLINE Link]. Attachment of medial collateral ligament components is pictured. In this lateral view, fragment is marked with circle. When the cartilage defect is more localized, surgery may be indicated. The anterior aspect of the distal femur (trochlea) meets the patella to form the patellofemoral articulation. Landin LA, Danielsson LG. 2010 Apr. 2020 Apr-Jun. Clin. J Bone Joint Surg Am. Medial epicondyle fractures also may be treated in a closed fashion if the medial epicondyle is nondisplaced, minimally displaced, or even displaced up to 15 mm (see the image below). Atlas Oral Maxillofac Surg Clin North Am. Acute nontraumatic adult knee pain: the role of MR imaging. More controversy exists with displacement of 5-15 mm. At 2 years postoperatively, the patient underwent a cavovarus foot reconstruction; however, patient continued to suffer from ankle pain (VAS 6) and ultimately underwent below knee amputation at 3 years . Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. The femoral condyles are located on the end of the thigh bone, or the femur. It articulates with the shin bone to make the tibiofemoral joint, which is better known as the knee. PMC J Bone Joint Surg Am. 2010 Feb. 92 (2):322-7. The missing piece of the trauma armoury-medial femoral condyle plate. 1997 Feb-Mar. Accurate apposition of the fracture surfaces is important to reduce the risk of growth-plate disturbance and to prevent loss of motion due to articular incongruence. This is the first report on a fracture of medial femoral condyle treated with this implant. [37, 38] and open fracture are indications for operative management. Mon - Fri: 8am - 8pm 2004;33 (10): 575-81. 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. Cavalieri-Pereira L, Spagnol G, Sverzut CE, de Moraes M, Trivellato AE. MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). [QxMD MEDLINE Link]. 2020 Sep. 29 (5):445-451. [QxMD MEDLINE Link]. The femoral condyles articulate, or contact, with the tibia and on the medial side this is in the medial tibial plateau and the medial meniscus and on the outside of the knee is known as the lateral tibial plateau in the lateral meniscus. The patient complained of severe pain in the right knee and could not move her knee. Note normal location somewhat posteriorly on distal humerus. Int. If there is a fracture (break) in part of the condyle, this is known as a fracture of the femoral condyle. Materials and methods J Clin Orthop Trauma. [QxMD MEDLINE Link]. This article discusses anatomic considerations, classification of condylar fractures, indications for surgery, treatment options, and complications. Surgical treatment and rehabilitation of medial Hoffa fracture fixed by locking plate and additional screws: A retrospective cohort study. 2019 Feb. 31 (1):86-91. Check for errors and try again. J Orthop Trauma. Epub 2012 Aug 2. 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. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: Reduce Pain Restore Movement Optimise Recovery What are Femoral Condyle Fractures? Ramnath RR, Kattapuram SV. In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. Careers. North Am. Please note: Our Online Booking tool is currently down, please contact us on 0330 088 7800 to arrange your appointment and we will honour any online booking discount. 2013;21 (2): 340-5. 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 one case, 40 of varus angulation was reported that went untreated for 4 years. [QxMD MEDLINE Link]. Share cases and questions with Physicians on Medscape consult. 2700 Vikings Circle Orthop. See this image and copyright information in PMC. MeSH -, Bel J.C., Court C., Cogan A., Chantelot C., Pietu G., Vandenbussche E., SoFCOT Unicondylar fractures of the distal femur. The plate was fixed provisionally and lag screw fixation was done with two cannulated cancellous screws. Any damage to the cartilage in the body in effect is arthritis. [QxMD MEDLINE Link]. 2014 Jul 26. Breer S, Oheim R, Krause M et-al. Pape D, Seil R, Kohn D et-al. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The medial and lateral condyles of the femur rest on the tibial plateau to form the tibiofemoral articulation. The femur is the longest bone in the body. Dakar Med. While it appears that many condylar fractures can be managed nonsurgically, recognition of cases that require surgical intervention and selection of an appropriate procedure are paramount to success in treating these injuries. 2015 Jul;19:95-102. doi: 10.1016/j.ijsu.2015.05.027. Others have recommended nonsurgical management, on the grounds that several long-term studies appeared not to substantiate significant valgus instability, even in individuals who went on to have radiographic nonunion of the epicondyle. Curr Opin Pediatr. 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 post-operative plain radiography and computed tomography. 8. Are you recovering from a fractured femoral condyle? 3 (4):352-4. You will likely be referred for CT, X-ray or MRI scans to determine the extent of the injury. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Formation of callus and fibrous tissue may obliterate the fracture site and cause a malunion that makes accurate dissection and reduction less accurate. Postoperative radiographs confirmed anatomical reduction, and the patient achieved a good result. Before He offers Online Physiotherapy Appointments. Clin Orthop Relat Res. Radiology of postnatal skeletal development. A report of 139 cases. On examination, bruising and tenderness were present on her head, back, right hip, right knee, and left shoulder. Radiol Med. [QxMD MEDLINE Link]. MeSH Physiotherapy is very important during the rehabilitation following a . The femur has another articulation with the patella, called the patellofemoral joint. This was treated with a supracondylar wedge osteotomy to restore ROM and correct the cubitus varus deformity. If the fragment is incarcerated in the joint, the incidence of ulnar nerve dysfunction can reach 50%. Please confirm that you would like to log out of Medscape. Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Most avulsion fractures heal very well without surgical intervention. Plate-and-screw fixation is another option. As a library, NLM provides access to scientific literature.
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