J Pediatr Orthop. Most of the other complications associated with medial epicondyle fractures are considered minor and do not result in a loss of function. [QxMD MEDLINE Link]. Note normal location somewhat posteriorly on distal humerus. 2004 May;33(5):260-4. doi: 10.1007/s00256-004-0751-4. In this procedure, small holes are made in the bone to try to induce some localized bone marrow elements, which may include stem cells, to form a fibrocartilage healing response. Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. 2021;40(5):443-57. The locking compression plate for proximal tibia is an acceptable solution for femoral medial condyle fracture. At the time the article was created Frank Gaillard had no recorded disclosures. Recognizing that spontaneous osteonecrosis of the knee was a misnomer and actually represents a subchondral insufficiency fracture that progressed to subchondral collapse with secondary osteonecrosis,the Society of Skeletal Radiology Subchondral Bone Nomenclature Committee recommended that "subchondral insufficiency fracture" be the preferred term 17. 2003. An official website of the United States government. Elbow dislocation associated with medial epicondyle fracture. Patient underwent TTR at 5 months postoperatively. Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. These are fractures that occur in the coronal plane rather than the more common sagital plane. As with any articular injury, anatomical restoration of the joint surface must be obtained, then lag screw fixation is required. Surg. 1997 Nov. 5 (6):303-312. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. Patel NM, Ganley TJ. Babal JC, Mehlman CT, Klein G. Nerve injuries associated with pediatric supracondylar humeral fractures: a meta-analysis. encoded search term (Medial Humeral Condyle Fracture) and Medial Humeral Condyle Fracture. 2012 Jun. (2019) AJR. Excision of the fragment does not appear to yield results comparable to those of nonoperative treatment. 1964 Sep. 4:592-607. Supracondyle wedge osteotomy has been advocated to restore anatomic angulation and motion loss from previous injury. Institutional review board approval was not required because all data were collected from clinical records and imaging systems for routine preoperative planning and follow-up. [QxMD MEDLINE Link]. Please enable it to take advantage of the complete set of features! Dr. Robert F. LaPrade operated on my right knee in May of 2010. The patient was referred to an or-thopaedic surgeon, who recommended conservative management. Distal Femur Fractures - Trauma - Orthobullets 2013 Feb;42(2):177-85. doi: 10.1007/s00256-012-1492-4. EDINA- CROSSTOWN OFFICE As a library, NLM provides access to scientific literature. 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. Gentle active range-of-motion (ROM) exercises may begin within 1 week after injury. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. Kirschner wires (K-wires) or cancellous screws may be used. 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. Unauthorized use of these marks is strictly prohibited. Int. Thus, fractures to this structure are either a medial femoral condyle fracture or a lateral femoral condyle fracture. Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension. Operative strategy in postero-medial fracture-dislocation of the proximal tibia. Each leg has two condyles, one medial (to the inner side of the knee) and one lateral (to the outer side of the knee). Fracture separation of the distal humeral epiphysis in children younger than three years old. Swelling can occur and bruising in many cases. Anteroposterior view after fixation. 2020 Nov-Dec;11(6):1072-1081. doi: 10.1016/j.jcot.2020.10.013. Skeletal Radiol. Skeletal Radiol. This answers all my questions! The blood supply to the epiphysis is through the soft-tissue attachments at the medial epicondyle. If the fragment is incarcerated in the joint, the incidence of ulnar nerve dysfunction can reach 50%. Maugars Y, Dubois F, Berthelot JM, Dubois C, Prost A. Lafforgue P, Pham T, Denizot A, Daumen-Legr V, Acquaviva PC. Editorially reviewed, not externally peer-reviewed. 1987 Jul-Aug. 7 (4):421-3. Epub 2002 Sep 21. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. 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. 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">. Lee A Patterson, MD Orthopedic Surgeon, Carolina Bone and Joint Clinic, PA, Lee A Patterson, MD is a member of the following medical societies: American Medical Association and South Carolina Medical Association. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: Reduce Pain Restore Movement Optimise Recovery What are Femoral Condyle Fractures? Hoppenfeld S, Murthy VL. In many studies, including long-term follow-up reports, patients treated nonsurgically had results similar to those of patients treated surgically, even for fracture fragments displaced as much as 15 mm. Results of a three-dimensional computed tomography analysis. HHS Vulnerability Disclosure, Help Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Epub 2021 Nov 18. The patient had an uneventful postoperative recovery. This is the first report on a fracture of medial femoral condyle treated with this implant. Accessibility Here, we present a case with femoral medial condyle fracture treated with a proximal tibial plate. The longer the inactivity and immobility the longer the recovery and rehabilitation is likely to take. This site needs JavaScript to work properly. A displaced medial condyle fragment or instability of the fragment with closed reduction is an indication for open reduction with rigid internal fixation. Gwathmey F.W., Jr., Jones-Quaidoo S.M., Kahler D., Hurwitz S., Cui Q. Distal femoral fractures: current concepts. Share cases and questions with Physicians on Medscape consult.