Oral Maxillofac Surg Clin North Am. The entity subsumes that previously known as spontaneous osteonecrosis of the knee (SONK/SPONK) or Ahlbck disease. Concomitant medial condyle fracture of the humerus in a childhood posterolateral dislocation of the elbow. Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands. 30 (3):253-63. J Orthop Trauma. PMC Skeletal Radiol. The authors concluded that favorable clinical and radiologic outcomes at long-term follow-up may be achievable by using two smooth K-wires for younger children and screw fixation for children near skeletal maturity. FOIA 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. 31 (3):331-3. Fracture of the medial condyle of the humerus in an elderly patient. Ann R Coll Surg Engl. encoded search term (Medial Humeral Condyle Fracture) and Medial Humeral Condyle Fracture. subchondral stress/fatigue fracture: overuse injuries in patients without associated risk factors 17. [QxMD MEDLINE Link]. A median nerve injury may occur as well; however, this is more common with an associated elbow dislocation. These fractures are called high-energy injuries due to the high forces needed to cause a break in this strong bone. The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7%, 53/70) and ipsilateral meniscal injury (94.1%, 64/68) were frequently associated. Nomenclature of Subchondral Nonneoplastic Bone Lesions. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Dependant on the injury the fracture may be close, meaning the skin is not broken or, open where the bone protrudes through the skin. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur. government site. 8th ed. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. Dr. Robert F. LaPrade operated on my right knee in May of 2010. If necessary, transposition of the nerve can be performed to reduce tension and prevent further injury. Disclaimer. Knee. [QxMD MEDLINE Link]. Suggestive changes were seen on initial roentgenograms in only one case, whereas increased radionuclide uptake was a consistent finding on the bone scan. Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Mirsky EC, Karas EH, Weiner LS. Management of condylar fractures - PubMed Because some cases of primary osteonecrosis may be secondary to undiagnosed stress-related microfractures, early diagnosis and elimination of weight bearing are essential. Closed reduction with cast immobilization is adequate for nondisplaced stable medial condyle fractures. For nondisplaced or minimally displaced medial epicondyle fractures, nonoperative management is the procedure of choice. J Orthop Traumatol. 2002 Jan-Feb. 22 (1):2-7. For other femoral condyle cartilage defects, it is important that one follow the basic principles of cartilage replacement to ensure the maximum outcome. Fracture of the Femoral Condyles - Physio.co.uk Spontaneous osteonecrosis of the knee (SONK). An official website of the United States government. Zukotynski BK, Alswang JM, Silva M. Medial Condyle Fractures of the Humerus in the Pediatric Population: Diagnostic Challenges: A Report of 3 Cases. 4 (1):98-101. J Clin Orthop Trauma. She did not present loss of consciousness, central nervous system dysfunction, or paralysis. Displacement patterns as described by Kilfoyle. Manfredini M., Gildone A., Ferrante R., Bernasconi S., Massari L. Unicondylar femoral fractures: therapeutic strategy and long-term results. If there is a fracture (break) in part of the condyle, this is known as a fracture of the femoral condyle. When the loss is related to another complication, such as nonunion, malunion, or heterotopic ossification, it can be significant. 81 (2):224-7. You will likely be referred for CT, X-ray or MRI scans to determine the extent of the injury. Restoration, stability, and postoperative radiographs were acceptable (Fig. 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 . Department of Orthopaedic Surgery, Yaizu City Hospital, Shizuoka, Japan. J Orthop Surg (Hong Kong). Each leg has two condyles, one medial (to the inner side of the knee) and one lateral (to the outer side of the knee). The major controversy involving medial epicondyle fractures has involved the management of displaced fractures. Subchondral hypointense fracture lines tend to resolve with conservative therapy. The plate was fixed provisionally and lag screw fixation was done with two cannulated cancellous screws. Past reports have shown the possibility of screw fixation plating for the fracture [2,[6], [7], [8], [9], [10]]. This is usually related to an overgrowth of the medial condyle. Microsurgery. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Mochizuki Y, Yamamoto N, Noda T, Ozaki T. Acta Orthop Traumatol Turc. The proximal tibial plate could become the method of choice for such fractures. Iowa Orthop J. Please enable it to take advantage of the complete set of features! In preparation for ORIF, the arm is placed in a posterior splint for stabilization, elevated, and treated with ice packs to decrease swelling. [Full Text]. Therapists must tailor their therapy plan to avoid contracture caused by calcification of the medial collateral ligament. At the latest follow-up, the patient achieved a range of motion of 0 to 120 and could walk without pain. [41] Good results have been reported with both operative and nonoperative treatment of the displaced medial epicondyle fracture. 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. Cartilage replacement surgeries commonly depend upon the size of the defect and the quality of the remaining cartilage edge. Malunion can result in loss of motion or angulation. An official website of the United States government. 1. Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles. Landin LA, Danielsson LG. A femoral condyle is the ball-shape located at the end of the femur (thigh bone). Also known as a bone marrow lesion, BME occurs when arthritis, an injury, or a fracture damages the normal bone structure. Misdiagnosis or delay in diagnosis or treatment increases the risk of impairment and complications. Elbow dislocation associated with medial epicondyle fracture. Resistance of four fixation techniques used to treat subcondylar fractures. The fragment is usually displaced distally and anteriorly. More profound ulnar nerve dysfunction has been observed to occur with manipulative reduction attempts, especially if closed manipulation of an incarcerated fragment is attempted. A posterior splint is then applied for at least 7-10 days until ROM is initiated. Elbow dislocation associated with medial epicondyle fracture. [QxMD MEDLINE Link]. 1971 Sep. 53 (6):1102-4. Skeletal Radiol. This is the first study to identify the incidence, risk factors, location and outcome of these fractures in an Asian population with modern posterior-stabilized (PS) TKA. [QxMD MEDLINE Link]. Are you recovering from a fractured femoral condyle? Bone Marrow Edema in the Knee: Causes, Symptoms, Treatment The goals of treatment include restoration of function and esthetics. Edmonds EW. 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. HHS Vulnerability Disclosure, Help This generalized information is a limited summary of diagnosis, treatment, and/or medication information. 2001 Sep. 83 (9):1299-305. Femoral medial condyle fracture is a rare fracture. Karlsson MK, Herbertsson P, Nordqvist A, Besjakov J, Josefsson PO, Hasserius R. Comminuted fractures of the radial head. 2009;114 (3): 437-47. Initially, the arm should be splinted in 90 of elbow flexion. [2, 3, 4, 6, 7, 8, 9, 10, 12, 31, 42], A longitudinal incision is made just anterior to the medial epicondyle. 1990. Hoppenfeld S, Murthy VL. The site is secure. Skaggs DL. Farsetti P, Potenza V, Caterini R, Ippolito E. Long-term results of treatment of fractures of the medial humeral epicondyle in children. The force of this event may even fracture other bones within the knee or legs. Whether this is best performed during growth or after the physis has closed has not yet been determined. With the elbow flexed and pronated, the fracture fragment is reduced and pinned with one or two K-wires. Features can vary depending on the stage and are best characterized on T2-weighted and proton density-weighted sequences. 2009. An 80-year-old woman was brought to our hospital with severe right knee pain after falling down 15 steps at her home. The anterior aspect of the distal femur (trochlea) meets the patella to form the patellofemoral articulation. Femoral medial condyle fracture is a rare fracture. Sunday: 9am - 4pm. Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. 2013;21 (2): 340-5. Results of a three-dimensional computed tomography analysis. Bookshelf One presumed mechanism of injury is a Stieda fracture (avulsion injury of the medial collateral ligament at the medial femoral condyle). A large bone fragment was identified attached to the MCL, of which the MCL is intact. J Bone Joint Surg Am. Lateral condyle fractures in children: evaluation of classification and treatment. Hoffa fracture of the femoral condyle: Injury mechanism, classification This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Treatment Bone marrow edema (BME) is when normal fatty bone marrow the spongy tissue in the center of bonesis replaced with a watery mix of fluid and blood. Positioning for valgus stress radiograph. Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases. 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. 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. Patient underwent TTR at 5 months postoperatively. government site. PMC . Gao M, Tao J, Zhou Z, Liu Q, Du L, Shi J. Int J Surg. JBJS Case Connect. FOIA 1996 Jul-Sep;63(7-8):475-9. 3D-Printed Total Talus Replacement After Free Vascularized Medial Clin. official website and that any information you provide is encrypted Displaced medial epicondyle fractures of the humerus: surgical treatment and results. The https:// ensures that you are connecting to the A 80-year-old woman fell down 15 steps at her home and reported to our hospital with severe right knee pain. 2007 Aug. 15 (2):170-3. Formation of callus and fibrous tissue may obliterate the fracture site and cause a malunion that makes accurate dissection and reduction less accurate. Chap 17. [QxMD MEDLINE Link]. 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.