Florida Man April 7, 2002, Swagtron Scooter Won't Turn On, Can You Charge A 20v Battery With A 12v Charger, Articles I

Kapoor et al[74] recommended a direct posterior approach and a lazy S-shaped incision to expose the fracture. [92] Moreover, if soft tissue embedded within the fracture line prevents reduction, arthroscopy can distinguish the tissues and the degree of damage to assist restoration. Unable to load your collection due to an error, Unable to load your delegates due to an error. [82,83] A biomechanical study by Li et al[84] demonstrated that plates combined with screws more firmly fixed the femoral condyle, reducing the probability of fracture displacement. (B) BULLET fixed at the entrance of the lateral bone canal of the distal femur. Li R, Guo G, Chen B, Zhu L, Lin A. Arthroscopicallyassisted reduction and fixation of an old osteochondral fracture of the lateral femoral condyle. The goals of treatment include restoration of function and esthetics. Redislocation in 37/75 patients followed for 6-24 years. 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. Rue JP, Busam ML, Detterline AJ, et al. Osteochondral fracture (OCF) in weight-bearing area of lateral femoral condyle (LFC) is a rare combined injury caused by patellar dislocation. Anatomic reduction of the articular surface, stable fixation, and early mobilization should be the aims of treatment. The patient was a 20-year-old man who sustained a noncontact left knee hyperextension injury while playing soccer. Search for Similar Articles Cruciate fracture of the distal femur: the double. Please enable scripts and reload this page. Cheng S, Zaidi SF, Linnau KF. Acta Orthop Traumatol Turc. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. After hospitalization, the patients underwent computed tomography scan and magnetic resonance examination. [100,101] To avoid damaging the cartilage in these cases, it is important to reduce the patella early and restore the patellofemoral joint stability by repairing the damaged medial soft tissues. [84]. 2020 The Authors. [38]. Onay T, Glabi D, olak , et al. Fracture and dislocation compendium: Orthopaedic Trauma Association Committee for Coding and, [35]. The bone mass is missing at the fracture. Friederichs MG, Greis PE, Burks RT. Lal H, Bansal P, Khare R, et al. [76]. Two patients with osteochondral injury of the weight-bearing portion of the lateral. Keyword Highlighting White EA, Matcuk GR, Schein A, et al. The injury to MCL was also observed with MRI. At Vitalis Physiotherapy, our treatment of femoral condyle fractures aims to: Reduce Pain Restore Movement Optimise Recovery What are Femoral Condyle Fractures? Nonunion of coronal shear fracture of femoral condyle. Impact fractures can be classified either as ductile or brittle depending on the elongation pattern that is present. may email you for journal alerts and information, but is committed Ji G, Wang S, Wang X, et al. 2007;41 Suppl 2:105-12. The risk of blood vessel damage when using this approach is minimal but the common peroneal nerve should be isolated first. Cureus 2016;8:e802. 3021 Tibial plateau fractures - fixation (a) Two or three lag screws may be sufficient for simple split fractures (type l), though 'b) a buttress plate ard screws may be more secure. [21] In contrast to unicondylar Hoffa fracture, a bicondylar Hoffa fracture is caused by a posterior and upward directed force and is not associated with knee valgus. Subchondral insufficiency fracture of the knee - Radiopaedia Epub 2018 Oct 4. Arthroscopy-assisted, [55]. Arastu MH, Kokke MC, Duffy PJ, et al. 1982;68:31725. A rare case of unicondylar medial, [24]. [29]. Suture anchors are drilled into the posterolateral tibia to repair the meniscus to the meniscosynovial junction. J Bone Joint Surg Am 2006;88:22704. Ul Haq R, Modi P, Dhammi I, et al. [77]. (B) MRI examination of the right knee joint: a patchy bone signal was seen in the anterior and lower part of the distal femur. Impaction Fracture of the Medial Femoral Condyle [97]. Comminuted fractures are a type of broken bone. Tan et al[75] recommended an improved posterolateral approach starting from the space between the peroneal nerve and the biceps femoris. A fracture is a broken bone. Intra-operative fractures in primary total knee arthroplasty - a 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. Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with [78]. According to the imaging results, patellar dislocation combined with OCF of LFC was considered in diagnosis. Visual observation revealed significant right knee effusion and an inability to bear weight on the right lower extremity or flex his knee beyond 80. Data is temporarily unavailable. [25] Loss of bone matrix results in brittle, weaker bones that break rather than bend with external force. When patients have tenderness along the medial edge of patella and knee joint effusion, it is necessary to actively improve MRI examination, to rule out osteochondral injury. 2). Injury 2015;46:41921. At present, open reduction is often used to treat osteochondral fractures. Surgical treatment of femoral medial condyle fracture with lag screws We searched Medline, Embase, Cochrane Library, Google Scholar, China National Knowledge Infrastructure, and China Biology Medicine disc, using the terms Hoffa fracture and coronal fracture of femoral condyle.. In these fractures, the popliteus tendon and the lateral head of the gastrocnemius muscle remain attached to the fragment. In addition, the Hoffa fracture line can be seen on stress films taken with the patient under general anesthesia. In the AO classification, Hoffa fracture is classified as type B3.2. Internal fixation with lag screws plus an antigliding plate for the, [88]. 2018 Oct;21(5):308-310. doi: 10.1016/j.cjtee.2018.08.004. [12,13] Most researchers[2,7,14] currently believe that when the knee is in 90 of flexion and emergency braking is performed while driving a car, an axial force in either a varus or valgus direction is transferred from the proximal femur to the femoral condyle. Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence. Transverse Hoffa's or deep osteochondral fracture? Clipboard, Search History, and several other advanced features are temporarily unavailable. [7]. doi: 10.1097/MD.0000000000032104. Injury 2005;36:8625. J Orthop Surg 2017;25:17. Type 2 fractures require a . Many author think these injuries are caused by the impact between the patella and femoral condyle with a knee flexed over 90. [20]. Reconstruction of Large Osteochondral Lesions in the Knee: Focus on Fixation Techniques. Plate fixation for Letenneur type I. [66]. Nonunion of a. Sanders TG, Paruchuri NB, Zlatkin MB. Report of 20 cases [in French]. Agarwal S, Giannoudis PV, Smith RM. Surgical versus nonsurgical treatments of acute primary patellar dislocation with special emphasis on the MPFL injury patterns. Arthroscopy 2011;27:81724. Hoffa's fractures. Acta Orthop Scand 1997;68:4246. Khle J, Angele P, Balcarek P, et al. The exposed fracture line is initially fixed with a k-wire and screws are placed perpendicular to the fracture surface. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating . Shah et al[19] systematically reviewed the recurrent patellar dislocation and found that the complication rate of patellar medial collateral ligament reconstruction was as high as 26.1%. Pathology. Hoffa fractures are most commonly caused by traffic accidents, especially motorcycle accidents. eCollection 2020 Jun. Appointments 216.444.2606. [19]. Somford MP, van Ooij B, Schafroth MU, et al. [81] For patients who require a longer healing time, such as those with a higher body mass index or poor compliance, the simple application of a cannulated screw is insufficient to counter the great shearing force between condyles and the tibial plateau when the knee is in flexion. Subchondral insufficiency fracture of the knee is not thought to be caused by bone death but instead by osteoporosis and insufficiency fractures, with histopathologically proven origins in weakened trabeculae and applied microtraumatic forces 6,13. d Department of Orthopedic Surgery, Second Peoples Hospital of Yuhang District, Hangzhou, Zhejiang, China. Jiang YR, Wang ZY, Zhang DB, et al. The white arrow indicate the defect area. Letenneur J, Labour PE, Rogez JM, et al. Dhillon MS, Mootha AK, Bali K, et al. [48]. Injury, 2005, 36: 862865. Arthroscopic management of a posterior femoral condyle (Hoffa) fracture: surgical technique. Bone contusion and associated meniscal and medial collateral - PubMed For example, a fracture line dividing the femoral condyle surface into 2 parts is classified as type I; 2 fracture lines dividing the femoral condyle surface into 3 parts is type II; and 3 or more fracture lines dividing the femoral condyle surface into 4 or more parts is type III. [101]. High-energy trauma is a common cause of a Hoffa fracture, although low-energy trauma and iatrogenic injury can also lead to these fractures. 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 . (LTC, Lateral Tibial Condyle.) [17]. [40]. Buttress plating for a rare case of comminuted medial condylar. Meyer C, Enns P, Alt V, et al. The work cannot be changed in any way or used commercially without permission from the journal. Jain A, Aggarwal P, Pankaj A. Concomitant ipsilateral proximal tibia and femoral Hoffa fractures. Injury 2011;42:14958. ASER Core Curriculum Illustration Project: coronal femoral condyle (Hoffa) fracture. Background The goal of this present study was to precisely determine the dimension and location of the impaction fracture on the lateral femoral condyle in patients with an ACL rupture. Valgus strain on the knee and the continuous pull of the quadriceps causes the patella to ride against the femoral condyle, resulting in rotation around its vertical axis. deep lateral sulcus sign - depression of lateral femoral condyle representing impaction fracture anterior tibial translocation sign Segond fracture arcuate fracture joint effusion CT Considered to have high specificity and sensitivity in detecting anterior cruciate ligament disruption 6. Allmann KH, Altehoefer C, Wildanger G, et al. Factors of patellar instability: an anatomic radiographic study. Authors Pathology The likely mechanism is a hyperextension or impaction injury with a collision of the femoral condyle and the posterior tibial plateau during the rotational movement responsible for injuring the ACL, most commonly the pivot-shift. Distal pulses and sensation were intact. The typical MRI findings after transient lateral dislocation of the patella have been well described and include a bone contusion pattern involving the inferomedial pole of the patella and the anterolateral aspect of the nonarticular portion of the lateral femoral condyle. Knee Surg Sports Traumatol Arthrosc. We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. As the knee is being extended and in full extension, it can be seen that femoral and tibial surfaces do not articulate with each other. (D) Under knee arthroscopy, obvious fracture line of lateral condyle of bone and osteochondral fracture of the lateral femoral condyle can be seen. Sun H, He QF, Huang YG, et al. Impact fractures are due to track formation and propagation. Gelber PE, Erquicia J, Abat F, et al. Bali K, Mootha AK, Krishnan V, et al. If radiographic findings are negative in questionable cases, CT and magnetic resonance imaging (MRI) should be performed. [102] Therefore, open reduction and internal fixation is recommended to minimize cartilage damage and allow appropriate treatment of the bone and soft tissues. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. Xray examination of right knee joint: free bone mass can be seen at, (A) MRI examination of the right knee joint: the bone continuity at the, (A) The fresh 1.5 cm 1.5 cm fracture surface of the lateral, (A) One 1.5 mm Kirschner wire temporarily fixed the fracture block of the, (A) Use of anterior cruciate ligament locator to assist drilling at the distal, (A) Through the hollow needle channel of the femoral intercondylar fossa, the folding, Surgical diagrams (A: osteochondral fracture, Surgical diagrams (A: osteochondral fracture of the lateral femoral condyle; B: fixation of, CT examination 6 months after operation: one screw internal fixation, regular external condyle, (A) A blurred fracture line can be seen at the fracture of the, MeSH [39,40] Wagih[41] reported that, under general anesthesia, patients with Hoffa fracture have instability at 30 of flexion but not with leg straightened. Lateral femoral notch sign (knee) | Radiology Reference Article Osteochondral Fracture Lateral Femoral Condyle Treated with - Hindawi We report a case of patellar dislocation with OCF in the weight-bearing area of LFC. Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. Wu, Liang MMa; Liu, Chao BMb; Jiang, Bing BMc; He, Lijiang MMd,*, a Department of Orthopedic Surgery, First Peoples Hospital of Linpin District, Hangzhou, Zhejiang, China, b Department of General Surgery, Medicine Faculty of Universitas Prima Indonesia, North Sumatra, Indonesia, c Department of General Surgery, Daocheng Country Peoples Hospital, Sichuan, China. [10]. [25] A cannulated screw combined with a plate is recommended in these cases. [103]. Uimonen M, Ponkilainen V, Paloneva J, Mattila VM, Nurmi H, Repo JP. [7]. [23]. Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature. Following Letenneur classification of coronal fractures of the femoral condyle in the 1970s and the publication of the second version of the Manual of Internal Fixation, the Hoffa fracture has become more widely recognized by orthopedists. The plate fit the bone surface well, despite some bending, the clinical and radiological outcomes were good. Irreducible, incarcerated vertical dislocation of patella into a. With a lower degree of knee flexion, the extensor mechanism is damaged below the patella (patellar tendon); at higher angles, the quadriceps tendon is torn. Shah JN, Howard JS, Flanigan DC, et al. Sahu RL, Gupta P. Operative management of, [44]. Gesslein M, Merkl C, Bail HJ, et al. Knee Surg Sports Traumatol Arthrosc. Knee flexion was limited less than 60 within 8 weeks after operation, partial weight-bearing was allowed at 8 weeks, followed by full weight bearing from 12 weeks after operation. Impaction Fracture of the Medial Femoral Condyle assessment of the anterior cruciate liga- ment with the anterior drawer and Lach- man tests was negative for laxity. Potini VC, Gehrmann RM. Radiographs and computed tomography demonstrated a femoral medial condyle fracture in the right knee (AO classification: 33-B2). Accessibility Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Chin J Traumatol 2011;14:1436. eCollection 2021 Jan. Uimonen MM, Repo JP, Huttunen TT, Nurmi H, Mattila VM, Paloneva J. Knee Surg Sports Traumatol Arthrosc. MRI reexamination at 18 months after operation showed that the osteochondral mass healed well (Figs. Li et al[25] used absorbable suture to treat OCF caused by patellar dislocation and achieved good medium-term results. Egol KA, Broder K, Fisher N, et al. The Authors. Osteochondral injury to the mid-lateral weight-bearing portion of the lateral, [14]. Type II is a fracture horizontal to the base of the posterior condyle with fracture lines located posterior to the attachment point of the lateral collateral ligament. J Knee Surg 2008;21:23540. 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. Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with Characteristics of Osteochondral Fractures Caused by Patellar Dislocation. [6]. The patient felt pain in his right knee and limited movement. [64]. Goel A, Sabat D, Agrawal P. Arthroscopic-assisted fixation of, [13]. Arthroscopic; Internal fixation; Osteochondral fracture; Suture anchor; TWINFIX Ti. Paa L, Vesel R, Koi J, et al. Tong W, Yang J, Xu PL, et al. Femoral Condyle Fractures - Symptoms, Causes, Treatment | Physio After operation, the fracture of femoral condyle healed well and the function of knee joint recovered gradually. Segmentation of the lateral femoral notch sign with MRI using a new A review of 23 patients. For bicondylar fractures, a median parapatellar incision can be used. Open reduction and internal fixation are preferred. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. J Surg Case Rep 2012;2012:10. Apropos of 128 cases]. In this paper, three cases of osteochondral fracture of lateral femoral condyle were treated with arthroscopic TWINFIX Ti suture anchor internal fixation, and good results were obtained. Conjoint bicondylar, [22]. The https:// ensures that you are connecting to the -, Patel JM, Saleh KS, Burdick JA, Mauck RL. Non-union coronal fracture femoral condyle, sandwich technique: a case report. 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. [61]. Type I, the most common classification, is a vertical fracture line parallel to the posterior cortex of the femur and involves the entire condyle. Min L, Tu CQ, Wang GL, et al. 2018;31:38291. Hoffa fragment associated with a femoral shaft fracture. Search for Similar Articles Sharath RK, Gadi D, Grover A, et al. 2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. Ostermann PA, Neumann K, Ekkernkamp A, et al. Pa a et al[17] reported that 10 patients with patellar osteochondral mass less than 2.7mm2 caused by patellar dislocation still achieved good function only by taking out the loose body, and no patellar dislocation was found. During the operation, 2 4.5mm anchor (Smith @ nephew TIWNFIX Ultra PK Suture Anchor) was inserted into the posterior edge and medial edge of the cartilage mass in the weight-bearing area, and then 2 non-absorbable sutures on each anchor were replaced by an absorbable suture (ETHICON VICRYL PLUS VCP359H), and finally the 2 ends of the absorbable suture were knotted to prevent sliding. findings identifies vascular segments with diminished flow vascular injury The patient was evaluated by the physical therapist 2 days after his injury. Screw insertion direction differs among operative approaches. [18]. The TT-TG Index: a new knee size adjusted measure method to determine the TT-TG distance. You will need surgery to repair your bone, and recovery can take a year or longer. Ercin E, Bilgili MG, Basaran SH, et al. Types I and III Hoffa fractures usually have a good prognosis because the soft tissue remains attached to the fragment, ensuring an adequate blood supply. Subchondral insufficiency fracture of the knee: a non-traumatic injury Arthroscopy. [65,67] Moreover, headless compression screws can prevent soft tissue irritation and do not need an additional countersinking procedure. Coronal fractures of the lateral femoral condyle. Epub 2007 Mar 23. Nomura E, Inoue M, Kurimura M. Chondral and osteochondral injuries associated with acute patellar dislocation. [96,97] Thus, closed reduction is recommended when Hoffa fracture is accompanied by patella dislocation. [19]. Am J Sports Med 2008;36:37994. Hoffa fractures are caused by shear stress between the femoral condyle and tibial plateau. For bicondylar Hoffa fractures, it is necessary to simultaneously expose both condyles[71] to allow proper reduction. A mechanical evaluation of two fixation methods using cancellous screws for coronal fractures of the lateral condyle of the distal femur (OTA type 33B). Conjoint bicondylar, [45]. Lowe M, Meta M, Tetsworth K. Irreducible lateral dislocation of patella with rotation. Knee Surg Sports Traumatol Arthrosc. [80] From a biomechanical point of view, when the load is in the vertical direction, posteroanterior screw placement has a lower risk of shifting than anteroposterior placement. J Bone Joint Surg Am 2005;87:5649. Familiarity with the characteristics of Hoffa fracture on various imaging modalities and an understanding of the mechanism and likelihood of combined injuries contribute to the timely and accurate diagnosis of Hoffa fracture and avoiding misdiagnosis. Osteochondral fractures of the lateral, [11]. Cartilage. [Treatment of extensive chondral defects of the patella after patellar dislocation]. Osteochondral fractures of the lateral. Low-energy trauma can cause Hoffa fractures in people with skeletal immaturity[24] as well as in those with low bone mass, such as patients with osteoporosis. [2] This fracture type was 1st described by Busch in 1869. After 1 year follow-up, good functional and radiographic outcome were obtained. 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%. Intra-operative fractures during primary total knee arthroplasty are rare with higher risk associated with osteoporosis, rheumatoid arthritis, advanced age, female gender, chronic steroid use, metabolic bone disorders, PS type of femoral implant and difficult surgical exposure of the knee joint due to severe deformities. Pure lateral blow-out fractures are rare, as the bone is thick and bounded by muscle. In the type I, an isolated fracture is confined to the coronal plane of 1 condyle (medial or lateral). Lateral femoral condyle osteochondral fracture combined to patellar According to the internal fixation principle, the antiglide plate should be fixed in the posterior position. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures . [13] There are also many reports on OCF in non-weight-bearing area of LFC. Reconstructive osteotomy for a malunited medial. Musculoskelet Surg 2012;96:4954. McCarthy JJ, Parker RD. [59]. Shetty GM, Wang JH, Kim SK, et al. 2013;37:238594. Skeletal Radiol 2015;44:3743. Jain SK, Jadaan M, Rahall E. Hoffa's fracture - lateral meniscus obstructing the fracture reduction - a case report. Unauthorized use of these marks is strictly prohibited. [30]. Callewier A, Monsaert A, Lamraski G. Lateral. Li ZX, Song HH, Wang Q, et al. 5cm cartilage mass was stripped from nonweight-bearing area of the LFC, and no osteochondral mass was found at the medial edge of patella (Fig. 2023 Jan;15(1):103-110. doi: 10.1111/os.13586. 2017;84:4417. J Orthop Trauma 1994;8:1426. [55] Onay et al[79] performed a long-term follow-up study of Hoffa fracture patients treated with screws and observed that the screws provided sufficient biomechanical stability until the fractures were healed. Nanda R, Yadav RS, Thakur M. Intra-articular dislocation of the patella. [ 21] Matthewson et al [ 21] reported for the first time that patellar dislocation complicated with OCF of LFC was treated with early Nandy K, Raman R, Vijay RK, et al. Moreover, even if the medial patellar retinaculum is strengthened, the patient still has symptoms such as anterior knee pain. On The 1st postoperative day, the injured limb should be mobilized on a continuous passive motion device. For young patients with good compliance, simple medial or lateral condylar fractures can be treated via a medial or lateral parapatellar approach. following anterior cruciate ligament repair) Location The recognized sites of osteochondral defects are: femoral condyle (most common in the lateral aspect of the medial femoral condyle) humeral head talus capitellum of the humerus Staging View Large Image Download Hi-res image Download (PPT) Intertrochanteric femoral fractures account for 3.13% of total adult fractures, 24.56% of femoral fractures, and 50% of proximal femoral fractures (Koval et al. Kondreddi V, Yalamanchili RK, Ravi Kiran K. Bicondylar Hoffa's fracture with patellar dislocation - a rare case. [75]. Marzouki A, Zizah S, Benabid M, et al. impacted and stress fractures. If fractures are present they are usually associated with orbital rim or other significant craniofacial injuries. Gao M, Tao J, Zhou Z, et al. 2021 Jan 26;9(1):2325967120974649. doi: 10.1177/2325967120974649. Nonunion of a, [62]. The CT classification[32] uses the anatomic femoral axis and a line parallel to the posterior cortex of the femoral condyle to divide the femoral condyle into a, b, and c regions. [98]. Surgical, [71]. This is the first case to apply the suture anchor system to the reduction and fixation of fracture. doi: 10.1016/j.eats.2020.02.016. Malays Orthop J 2017;11:204. Chin J Orthop Trauma 2009;9:8503. CT examination 6months after operation: one screw internal fixation, regular external condyle cortex, good alignment at the end of fracture, callus growth and unclear fracture line could be seen in the right lateral femoral condyle.