![]() ![]() Patient was planned for open reduction and internal fixation, under all aseptic conditions, spinal and epidural anaesthesia, fixation patient was performed in supine position. On evaluation patient complained of pain and inability to move right lower limb, there was swelling and bruising over the knee, tenderness was elicited on palpation, distal neurology and vascularity were intact radiographs was done which demonstrated (Figure 1) a femoral medial condyle fracture of right side, the fracture was intra articular and simple oblique through the intercondylar notch (AO classification 33-B2) patient was admitted to our hospital for open reduction internal fixation to be performed following day after stabilization.įigure 1: radiograph done at time of presentation Parkinson’s disease or stroke or paralysis any signs of central nervous dysfunction or paralyses, all her vital signs were normal. She was not suffering from chronic neurological illnesses. We present a case of femoral medial condyle fracture treated with cancellous screws and posterior tibial plate used as anti-glide plate/buttress plate.Ī 78-year-old woman was brought to our hospital after sustaining trauma to her right knee due to fall from stairs. ![]() Considering the vertical line of fractures and the obliquity of the displacement, screw fixation compression can be done but to achieve stability however no current anatomical plates fit the femoral medial condyle. The plate must be precontoured to match posterior surface of distal femur to offer adequate compression till healing and combination construct was needed to be used. However, this compression in other plane could not be achieved through single plane orientation of the plate hence needs isolated another fixation modality. Proximal end of the fracture being smaller in dimension to accommodate the lag screw. Hence compression could only have been achieved when screws are placed in the tangential plane to the plane of fracture line. However, in this case the spiral fracture pattern in distal femur metaphysic the fracture line itself has extended into two planes, Proximal fracture pattern was in coronal orientation and distal in sagittal plane. Being metaphyseal region and intra-articular extension, anatomical reduction, and compression as well as stable fixation is a primary necessity to achieve better functional outcome. Limited literature is available to give clear view regarding treatment of this fracture configuration. Femoral medial condyle fracture (AO classification 33-B2) is a considerably rare fracture. However careful patient selection is important.ĭistal femur fractures account for 7% of all femur fractures if hip fractures are excluded then one third of femur fractures involve the distal portion, a bimodal age distribution exists with high incidence in young males due to high energy trauma such as motor vehicle or motorcycle accidents or fall from heights a second peak in elderly woman from minor falls there is ratio of 1:2 in men to women. The patient had uneventful post-operative recovery and recent follow up patient achieved a range of motion of zero to 120 degree and could walk without pain.Ĭonclusion: The locking compression plate for proximal tibia can be used solution for difficult femoral condyle fracture used in reversed position. ORIF was done using two 6.5 mm partially threaded cancellous lag screws to compress the condyle and posteriorly extending oblique pattern of fracture compressed by proximal tibia posterior plate as anti-glide plate. All pre anaesthetic investigations performed and patient was planned for open reduction internal fixation. It is classified (AO classification 33-B2) Patient was initially stabilised and immobilised in splintage. Knee radiographs (Figure 1) revealed right femoral medial fracture in spiral configuration extending into intercondylar notch as well as breaking in posterior cortex. Introduction: Fractures of medial condyle of femur are typically rare here we report a case of medial femoral condyle fracture with multiplanar displacement treated with cortico-cancellous screw for compression and posterior tibial plate used as an anti-glide plate/buttress for oblique/spiral configuration of fracture.Ĭase Presentation: A 78-year-old woman sustained trauma due to fall from stairs and was brought to our hospital with severe right knee pain and inability to bear weight and walk. ![]()
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