impaction fracture lateral femoral condyle treatment

[3,4] In 1888, Hoffa described coronal fracture of the femoral condyle but did not indicate the source of the previous reference. This site needs JavaScript to work properly. -, Enea D, Busilacchi A, Cecconi S, Gigante A. Latediagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent: a case report. Screw insertion direction differs among operative approaches. In general, there has been a trend toward . [58]. A fracture is a broken bone. Choudhary RK, Tice JW. Among the various types of Hoffa fractures, the Letenneur II is unique because the fragments are small and difficult to fix, and poor blood supply to the fragments impairs its healing. Busam ML, Provencher MT, Bach BR. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. Bauer KL. The patient was referred to an or- thopaedic surgeon, who recommended conservative management. [104]. If fractures are present they are usually associated with orbital rim or other significant craniofacial injuries. femoral shaft fracture presentation MRI reexamination at 18 months after operation showed that the osteochondral mass healed well (Figs. (A) MRI examination of the right knee joint: the bone continuity at the edge of the lateral condyle of the right femur was poor, the patchy high signal intensity was seen in the bone marrow cavity of the lateral condyle of the femur, and the local cartilage became thinner in the corresponding area. Khle J, Angele P, Balcarek P, et al. The authors have no funding and conflicts of interest to disclose. The patellar height was in the normal range (Caton-Deschamp index 1.0). 0cm osteochondral mass was stripped from the weight-bearing area of the LFC, 2.0*0. Chauhan A. Irreducible, incarcerated vertical dislocation of the patella into a. Biau DJ, Schranz PJ. Nork SE, Segina DN, Aflatoon K, et al. 8600 Rockville Pike The natural history. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2018;31:38291. Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws. The main cause of a Hoffa fracture is a high-energy injury such as those sustained in traffic collisions (80.5% of cases) and falls (9.1% of cases). Coronal MRI images were reexamined 18 months after operation, MRI = magnetic resonance. Improving the accuracy and timeliness of Hoffa fracture diagnosis and improving minimally invasive treatment outcomes remain the focus of orthopedic surgeons. The risk of blood vessel damage when using this approach is minimal but the common peroneal nerve should be isolated first. Malays Orthop J 2017;11:204. Rev Chir Orthop Reparatrice Appar Mot. [9]. Cheng S, Zaidi SF, Linnau KF. [16]. Zhao LL, Tong PJ, Xiao LW. Singh R, Singh RB, Mahendra M. Functional outcome of isolated Hoffa fractures treated with cannulated cancellous screw. National Library of Medicine government site. Recently, impaction fractures in the non-weight-bearing area of the lateral femoral condyle were reported in 16 of 6600 patients who underwent knee MRI. your express consent. Fracture and dislocation compendium: Orthopaedic Trauma Association Committee for Coding and, [35]. Complications of humerus fracture treatment. Soft tissues are retracted to . Conjoint bicondylar, [22]. In reviewing left knee radiographs that had previously been interpreted as normal, the physical therapist noted an abnormally deep depression of the medial condylopatellar sulcus, which was concerning for a possible impacted osteochondral fracture. (C) The free edge of the anterior foot of the meniscus was rough (degree I). (A) One 1.5mm Kirschner wire temporarily fixed the fracture block of the lateral condyle of the femur. At the same time, forces on the distal tibia are transferred to the tibial plateau, resulting in great shear stress between the femoral condyle and the tibial plateau. The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request. Therefore, further studies are needed to improve the quality of Hoffa fracture reduction under arthroscopy. J Trauma 2000;48:15960. [102] Therefore, open reduction and internal fixation is recommended to minimize cartilage damage and allow appropriate treatment of the bone and soft tissues. [11,12] The bone marrow edema at the posterolateral aspect of the LFC suggest that the knee joint is highly flexed during patellar dislocation. 3 Although the examined patients were not professional athletes, some differences between these groups are worth mentioning: in the athletes, the medial rather than the lateral condyle was 1 It has been proved that compression of the posterior border of . However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. [64] Open reduction and internal fixation is the 1st choice for the treatment of displaced Hoffa fractures, and it is also suitable for the treatment of nondisplaced Hoffa fractures. Repair of displaced partial articular fracture of the distal femur: the. In the AO classification, Hoffa fracture is classified as type B3.2. 1). Intertrochanteric Fractures of the Femur | SpringerLink The bone contusions on the lateral femoral condyle, lateral aspect of the tibial plateau, medial femoral condyle, and medial aspect of the tibial plateau were documented. The advantage of this approach is that it does not compromise future arthroplasty surgery; however, it does not allow visualization and treatment of any posterior comminution. Weight bearing is allowed with radiographic evidence of healing, which usually occurs by 10 weeks of the postoperative period.[55]. 2013;33:5118. Search for Similar Articles [18]. Internal fixation with lag screws plus an antigliding plate for the, [88]. Keywords: 1996 ). Arthroscopy. [54] However, popliteal and gastrocnemius muscle traction and foot or ankle movement can lead to fracture redisplacement,[5557] which can cause delayed fracture healing, nonunion, traumatic arthritis, knee dysfunction, and other complications. 2004 Jan-Feb;142(1):103-8. doi: 10.1055/s-2004-817655. Lateral radiographs of the affected knee were inspected for a . Introduction. A case report. Effectiveness of a footprint guide to establish an anatomic femoral tunnel in anterior cruciate ligament reconstruction: computed tomography evaluation in a cadaveric model. Acta Orthop Belg 2001;67:1328. [43] If radiographic examination is not diagnostic but a Hoffa fracture is suspected, a CT scan, which is the gold standard for diagnosis of a Hoffa fracture, should be performed. PMC Dave LY, Nyland J, Caborn DN. In these cases, avulsion of the anterior cruciate ligament along with a large chunk of bone at its insertion[17] can lead to a Hoffa fracture. Twenty-seven-year nonunion of a. Reconstructive osteotomy for a malunited medial. One hundred five relevant articles were reviewed, and the clinical knowledge base was summarized. Other structures may be fractured at the same time due to the great forces experienced through the femur bones. What is an Impact Fracture? - Definition from Corrosionpedia Intraoperative, [12]. Anchor absorbable suture bridge fixation is rigid enough, which can avoid second operation, save cost and good outcome could be expected, which is worth exploring; Of course, a large number of clinical data are needed for further comparative study. Cancellous screws cannot achieve adequate compression[55] and require more surgical time to countersink. Injury 1989;20:3714. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. Werner BC, Miller MD. to maintaining your privacy and will not share your personal information without According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis. Injury 2005;36:8625. [79]. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. Redislocation in 37/75 patients followed for 6-24 years. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. YZ and YP contributed equally to this work. Lateral femoral condyle osteochondral fracture combined to patellar J Orthop Trauma 2002;16:17881. Int Orthop 2015;39:124550. Cruciate fracture of the distal femur: the double. After 6 months, the patient could resume normal sporting activities, and the knee joint extension and flexion were normal without knee instability and pain. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. -. [6,45,48,5863] Therefore, we must strictly control the indications for conservative treatment. Skeletal Radiol 2015;44:3743. Treatment of osteochondral fracture of lateral femoral : Medicine [30]. 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. Partial ceramic crowns: influence of ceramic thickness, preparation design and luting material on fracture resistance and marginal integrity in vitro. Introduction. eCollection 2020 Jun. Life (Basel). Akan K, Akgun U, Poyanli O, et al. Lateral Femoral Condyle (LFC) osteochondral fracture (HSL, Hill-Sachs-like Lesion) can be seen in 30 of knee flexion. Sagittal, fat-suppressed, proton density-weighted magnetic resonance image of the left knee demonstrating a focal indentation of the anterior portion of the medial femoral condyle (orange arrow . The association between supracondylar-intercondylar distal femoral fractures and coronal plane fractures. Incarcerated patellar tendon in. Impaction fracture of the medial femoral condyle - PubMed Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. Lian X, Zeng YJ. Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. [82]. [21,22], In some patients, a Hoffa fracture is associated with a patellar fracture. 2022 Dec 16;101(50):e32104. Monocondylar fractures of the femur: a review of 13 patients. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . Patellar dislocation with OCF in weight-bearing area of LFC is a rare injury in adolescents. [103]. Nonunion of a. 2017;30:37884. A meta-analysis by Khle et al[6] show that there is no unified treatment for osteochondral fractures (OCF) of knee joint at present, and the overall failure rate is 17%. doi: 10.1016/j.arthro.2006.11.029. In these cases, magnetic resonance imaging (MRI) can show a lateral femoral notch sign: a depression in the lateral femoral condyle, which could indicate an ACL tear . Operative. J Orthop Trauma 1994;8:1426. After 1 year follow-up, good functional and radiographic outcome were obtained. J Bone Joint Surg Am 2008;90:46370. [1] A Hoffa fracture, a rare fracture confined to the coronal plane of either femoral condyle, accounts for 8.7% to 13% of distal femoral fractures. By definition, secondary osteonecrosis of the knee occurs secondary to an insult. Furthermore, a Hoffa fracture is associated with cruciate ligament injury. [7]. The term comminuted fracture refers to a bone that is broken in at least two places. Two bone tunnels are made from anteromedial to posterolateral with 2mm Kirschner wire at the front edge of osteochondral mass. This rare lesion is diagnostically challenging and requires an adapted and prompt treatment. [5] Viskontas et al[69] reported an extensile medial subvastus approach that allows better exposure of the surgical field and protects the blood supply of the bones comparing with the medial parapatellar approach. Medicine101(50):e32104, December 16, 2022. [7]. Jain A, Aggarwal P, Pankaj A. Concomitant ipsilateral proximal tibia and femoral Hoffa fractures. Ul Haq R, Modi P, Dhammi I, et al. Irreducible, incarcerated vertical dislocation of patella into a. Osteochondral injury after acute patellar dislocation in children and adolescents. After the osteochondral mass was fixed in situ to the lateral condyle of the femur, 2 suture ends of the posterior suture anchor penetrate into the front bone tunnels respectively, and after penetrating from the LFC, they are knotted and fixed with 2 suture ends of medial suture anchor respectively (Fig. impacted and stress fractures. The goals of treatment include restoration of function and esthetics. Osteochondral fractures of the lateral, [11]. Impaction Fracture of the Medial Femoral Condyle - JOSPT Tripathy SK, Aggarwal A, Patel S, et al. J Surg Case Rep 2012;2012:10. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. [43]. [73] This approach is suitable for the treatment of Hoffa fracture with patella dislocation. The authors have no conflicts of interest to disclose. Jabalameli M, Bagherifard A, Hadi H, et al. 5 and 6), and the lysholm score was 95 points, which was very good. Dejour H, Walch G, Nove-Josserand L, et al. Received: 27 October 2022 / Received in final form: 8 November 2022 / Accepted: 9 November 2022. Technique for Treatment of Subchondral Compression Fracture of the Lateral Femoral Condyle Associated With ACL Tear Technique for Treatment of Subchondral Compression Fracture of the Lateral Femoral Condyle Associated With ACL Tear Arthrosc Tech. Lax patellar attachments are thought to place adolescent boys at higher risk of patellar dislocation. [2,77] The heads of screws placed through the articular cartilage are countersunk to prevent damage to the cartilage. Mashoof AA, Scholl MD, Lahav A, et al. Impact fractures can be classified either as ductile or brittle depending on the elongation pattern that is present.

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