[Resorbable pin refixation of an osteochondral fracture of the lateral femoral condyle due to traumatic patellar dislocation: case management, follow-up and strategy in adolescents]. Shetty GM, Wang JH, Kim SK, et al. Xray examination of right knee joint: free bone mass can be seen at the anterior edge of the femur in the knee joint. A patient, 15-year-old, female student. 4). 1). Oper Dent 2007;32:25160. Ji G, Wang S, Wang X, et al. -, Morris John K, Weber Alexander E, Morris Mark S. Adolescent femoral chondral fragment fixation with polyLlactic acid chondral darts. Epub 2020 Sep 18. We report a case of patellar dislocation with OCF in the weight-bearing area of LFC. Orthopedics, 2016, 39: e362e366. [5-9] For children and individuals with osteoporosis, low-energy trauma can also lead to a Hoffa fracture. J Orthop Trauma 1999;13:13840. [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. Comminuted fractures are a type of broken bone. Introduction. [72]. This article discusses anatomic considerations, classification of condylar fractures, indications for surgery, treatment options, and complications. lateral femoral condyle fractures in 80% Angiography indications ankle-brachial index (ABI) <0.9 obvious signs of vascular injury i.e., hard and soft signs (pulselessness, rapidly expanding hematoma, massive bleeding, etc.) Arthroscopic. Three types of fracture are defined based on the coronal fracture line (Fig. Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with We used anchor absorbable suture bridge to fix osteochondral mass, and obtained good functional and imaging results at the final follow-up. High-energy trauma is a common cause of a Hoffa fracture, although low-energy trauma and iatrogenic injury can also lead to these fractures. Lee SY, Niikura T, Iwakura T, et al. Calmet J, Mellado JM, Garcia Forcada IL, et al. When high-energy trauma involves the distal femur, the lateral condyle is often damaged[18] before the medial condyle because of the physiologic genu valgum of the knee joint. J Bone Joint Surg Am 2005;87:5649. [16]. Federlin M, Krifka S, Herpich M, et al. One hundred five articles on Hoffa fractures were reviewed, and the clinical knowledge base was summarized. J Orthop Surg 2017;25:17. [39]. Radiographs of knee joint show loose body in joint. Previous article . [96]. Gao et al[70] reported a medial to medial-posterior distal femur approach in which the fragments were exposed through the interval space between the gracilis muscle and medial head of the gastrocnemius and the medial collateral ligament can be clearly exposed and protected. 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. [75]. 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.. Femoral Condyle Fractures are a painful condition which can result from trauma injuries to the thigh bone and/or knee. Lateral femoral notch sign (knee) | Radiology Reference Article [102]. Many author think these injuries are caused by the impact between the patella and femoral condyle with a knee flexed over 90. your express consent. J Orthop Trauma 2006;20:2736. AIMER was located at the outlet of the medial bone canal of the lateral condyle of the femur, and the HANDLE was adjusted to a suitable angle (5060). (C) Making a small incision on the outside of the knee joint, it is convenient to drill two 2.0mm bone channels from the distal end of the femur from the outside to the intercondylar fossa. [79]. 2007 Oct;23(10):1133.e1-4. After operation, the fracture of femoral condyle healed well and the function of knee joint recovered gradually. Moreover, the placement of a posterior antiglide plate with screws strips more soft tissue, especially the insertion of the gastrocnemius heads, and may destroy the blood supply to the fragments. The funding sources have no role in study design, literature collection, review, data analysis, and manuscript preparation. [82]. [9] The pain due to these combined injuries often exceeds that caused by the Hoffa fracture, which can lead physicians to miss the latter. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. 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 [11,12] The bone marrow edema at the posterolateral aspect of the LFC suggest that the knee joint is highly flexed during patellar dislocation. to maintaining your privacy and will not share your personal information without The Authors. [17]. Baker BJ, Escobedo EM, Nork SE, et al. [65,67] Moreover, headless compression screws can prevent soft tissue irritation and do not need an additional countersinking procedure. At present, open reduction is often used to treat osteochondral fractures. Tsai et al[103] reported that surgical treatment is the 1st choice for Hoffa fracture accompanied by traumatic patella dislocation; if conservative treatment is adopted, the redislocation rate is as high as 40%. We replaced the anchor suture with (ETHICON VICRYL PLUS VCP 359H) suture during the operation, which is an attempt based on the research of Li,[25] in order to avoid the second operation. Nork SE, Segina DN, Aflatoon K, et al. Repair of displaced partial articular fracture of the distal femur: the. Osteochondral injury after acute patellar dislocation in children and adolescents. [19] Therefore, lateral condyle fracture is significantly more common than medial condyle fracture. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. Am J Sports Med 2008;36:37994. 2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. Autologous Osteoperiosteal Transplantation for the Treatment of Large Cystic Talar Osteochondral Lesions. Buttress plating for a rare case of comminuted medial condylar. Operative, [46]. Twenty-seven-year nonunion of a. Weight bearing is allowed with radiographic evidence of healing, which usually occurs by 10 weeks of the postoperative period.[55]. 2001;17:5425. J Trauma 2000;48:15960. [21]. With rapid developments in transportation, construction, and industry, the incidence of Hoffa fractures has gradually increased. [3]. [27]. findings identifies vascular segments with diminished flow vascular injury 2017;84:4417. Arthroscopy. Orbital blow-out fracture | Radiology Reference Article | Radiopaedia.org Injury 2005;36:8625. This approach fully exposes the fracture and does not risk damaging the nerves and blood vessels,[67] making the operation simple and safe. [Treatment of extensive chondral defects of the patella after patellar dislocation]. J Orthop Trauma 1994;8:1426. Tsai CH, Hsu CJ, Hung CH, et al. your express consent. J Knee Surg 2013;26(Suppl 1):S8993. FIGURE 2. Hoffa fragment associated with a femoral shaft fracture. Zhou et al[26] used suture anchor to treat LFC OCF under arthroscope, and achieved good clinical results. What is an Impact Fracture? - Definition from Corrosionpedia Coronal plane fracture of the femoral condyles: anatomy, injury patterns, and approach to management of the Hoffa fragment. Lewis SL, Pozo JL, Muirhead-Allwood WF. Oral application of Qiangguyin Keli and alendronate sodium vitamin D3 tablets in postoperative anti-osteoporosis. 2013;33:5118. Coronal plane partial articular fractures of the distal femoral condyle: current concepts in management. femoral shaft fracture presentation Nakagawa S, Arai Y, Inoue H, et al. 2018;31:38291. 2021 Jun 10;11(6):543. doi: 10.3390/life11060543. For complex fractures in patients with osteoporosis or a high body mass index, cannulated screws with antigliding plate fixation should be used. chauffeur fracture: intraarticular fracture involving radial styloid; Another type of distal radius fracture is the Lister's tubercle fracture. Gesslein M, Merkl C, Bail HJ, et al. However, in recent years, some authors[35] reported OCF involving the weight-bearing area of LFC. J Bone Joint Surg Am 2006;88:22704. You may be trying to access this site from a secured browser on the server. [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. 2013;37:238594. A review of 23 patients. Choudhary RK, Tice JW. The patient was referred to an or- thopaedic surgeon, who recommended conservative management. [15,1720] The fracture line its inclination angle of a Hoffa fracture depend on the degree of knee joint flexion at the time of trauma[18]; as the angle of knee flexion increases, the fracture line will occur farther from the posterior cortex of the femoral-condyle. MRI reexamination at 18 months after operation showed that the osteochondral mass healed well (Figs. Keyword Highlighting However, some patients had suture removal during the second arthroscopy because of suture irritation. Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence. [90]. J Orthop Trauma 2002;16:17881. Hoffa fracture with cruciate ligament, lateral collateral ligament, or meniscus injuries can be treated with arthroscopic surgery,[90] which has the advantages of minimal invasion, less of an effect on blood supply, early postoperative return to functional exercise, and effective prevention of nonunion and joint stiffness. Before The exposed fracture line is initially fixed with a k-wire and screws are placed perpendicular to the fracture surface. [5]. J Bone Joint Surg Br 1989;71:11820. Bone contusion and associated meniscal and medial collateral - PubMed Incarcerated patellar tendon in. Lateral femoral condyle osteochondral fracture combined to patellar 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. 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. [12,37] Orthopedic surgeons treating these patients should be vigilant in diagnosing a Hoffa fracture; patients with undiagnosed injuries experience long-term knee pain and limited knee mobility. Research Article: Systematic Review and Meta-Analysis. Am J Sports Med. Unfallchirurg 2004;107:1521. For more information, please refer to our Privacy Policy. J Pediatr Orthop. [6]. Your message has been successfully sent to your colleague. [93] The biggest challenge in the treatment of Hoffa fractures under arthroscopy due to the patella is dissecting the fragments for reduction[94] and placing screws perpendicularly into the fracture line. [19]. After fracture exposure, headless compression screws can be inserted perpendicularly to the fracture line from posterior to anterior. You may search for similar articles that contain these same keywords or you may A rare case of unicondylar medial, [24]. The bone mass is missing at the fracture. However, the latest biomechanical study[88] showed that lateral antiglide plate has greater anti-shearing strength than posterior fixation. osteochondral impaction fracture postsurgical (e.g. The appropriate surgical plan is chosen based on the location of the Hoffa fracture, characteristics of the fracture line, fracture severity, and associated injuries. [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. Medline, Embase, the Cochrane Library, Google Scholar, the China National Knowledge Infrastructure, and the China Biology Medicine disc were searched for relevant articles. Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws. Therefore, further studies are needed to improve the quality of Hoffa fracture reduction under arthroscopy. [76,77] Fixation with 2 or more screws can prevent rotation and rotational displacement. A biomechanical study[5] shown that several smaller-diameter screws cause less damage to the joint cartilage than larger-diameter screws but that both have the same tensile force. Impaction fracture of the medial femoral condyle - PubMed Injury 2018;49:398403. Westmoreland GL, McLaurin TM, Hutton WC. -. Smith EJ, Crichlow TP, Roberts PH. Ercin E, Bilgili MG, Basaran SH, et al. 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. Other structures may be fractured at the same time due to the great forces experienced through the femur bones. Gang et al[20] found that there was no statistically significant difference between surgical treatment and non-surgical treatment in patients with patellar side injury of medial collateral ligament of patella. Subchondral impaction fractures of the non-weight-bearing - PubMed In some cases, the Letenneur II fragment is small but essential for the knee join when flexed at 90 because it ensures the articular surface integrity. Anchor absorbable suture bridge fixation for this kind of OCF is not only effective, but also economical. 2004 Jan-Feb;142(1):103-8. doi: 10.1055/s-2004-817655. When the patient has patellar dislocation with OCF in the weight-bearing area of LFC, surgical treatment and internal fixation is the treatment of choice if the OCF can be fixed. Am J Sports Med. Manfredini M, Gildone A, Ferrante R, et al. Acta Orthop Scand 1997;68:4246. [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. 2018 Oct;21(5):308-310. doi: 10.1016/j.cjtee.2018.08.004. Materials and methods: This HIPAA-compliant retrospective study was approved by our Institutional Review Board. A 15-year-old female student accidentally sprained her right knee while participating in sports activities. Med Sci Monit, 2012, 18: CS117CS120. If radiographic findings are negative in questionable cases, CT and magnetic resonance imaging (MRI) should be performed. J Orthop Surg Res 2012;7:21. [53]. Werner BC, Miller MD. [18]. computed tomography scan and magnetic resonance (MRI) examination of knee joint further confirmed loose body within the knee joint, osteochondral defect in weight-bearing area of LFC and avulsion of medial patellofemoral ligament (Fig. Coronal fractures of the medial femoral condyle: a series of 6 cases and review of literature. [2,77] The heads of screws placed through the articular cartilage are countersunk to prevent damage to the cartilage. 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). Bali K, Mootha AK, Krishnan V, et al. [47]. In anterior cruciate ligament reconstruction, an anterior medial approach to the femoral tunnel allows restoration of the position of the tendon graft and increases rotation stability when an expanded bone tunnel is used for the graft. [25] A cannulated screw combined with a plate is recommended in these cases. A radiographic examination should include anteroposterior, lateral, oblique, and stress views of the knee. Intraoperative, [12]. Fracture and dislocation compendium: Orthopaedic Trauma Association Committee for Coding and, [35]. National Library of Medicine Lateral radiographs of the affected knee were inspected for a . Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients.
Under Canvas Yosemite Opening Date,
Union Furniture Company Jamestown, Ny,
Sunday Law Update Stateline Sda,
Articles I