Medial Condyle

Fig.2.6a,b. Lateral knee. Centre On the medial condyle of the knee with a 3-5° cranial angulation along the femur. Area imaged 1o include the whole of the patella and the proximal portion of the tibial tuberosity... 

SH III and IV are uncommon and they may be unicondylar or bicondylar. With SH III, the fracture line often extends through the intercondylar region and the physeal separation is of the medial condyle. 

An estimation of the distribution of fracture patterns about the elbow is supracondylar (70%), lateral condyle (15%), medial epicondyle (10%), olecranon (5%), radial neck (1%), medial condyle (1%), capitel-lum (1%), T condylar (<1 %). 

The blood supply to the trochlea is via two terminal interosseous branches of the recurrent ulnar artery, the lateral trochlea and medial trochlea arteries. The medial artery maybe damaged in fractures of the medial condyle, leading to avascular necrosis. 

Some fractures may be reduced by closed manipulation and stabilisedby percutaneous K-wires. Evaluation of fracture reduction may be aided by intraoperative arthrogram. The most stable and therefore ideal configuration of K-wires is for a common entry point on the lateral edge of the condyle, with one wire running transversely to the medial condyle, and the second at about 60 aiming at the medial cortex above the olecranon fossa. 

Based on AP and lateral radiographs, the normal curve following around the medial condyle is disrupted. In type III injuries, it can be easy to misinterpret the radiographs as normal, since the fragment may be difficult to identify, particularly on the AP view. It is important that the acronym CRITOE is used to assess the ossification centres about the elbow joint. The medial epicondyle ossifies before that of the trochlea. If the trochlea is seen then the medial epicondyle must be present (Fig. 18.14). A displaced medial epicondyle lying within the elbow joint should not be confused with the ossification centre of the trochlea. The diagnosis should always be considered if the epicond)de cannot be visualised at an age when it should be present. 

Extension inj uries are reduced by placing the arm into full extension, correcting the varus or valgus, treating the associated injury such as radial head or medial condyle fracture, before immobilising in a cast for 3 weeks in slight flexion. 

Kilfoyle RM (1965) Fractures of the medial condyle and epi-condyle of the elbow in children. Clin Orthop 41 43-47 Lee SS, Mahar AT, Miesen D, Newton PO (2002) Displaced pediatric supracondylar humerus fractures biomechanical analysis of percutaneous pinning techniques. J Pediatr Orthop 22 440-443... 

Leet AI, Young C, Hoffer MM (2002) Medial condyle fractures of the humerus in children. J Pediatr Orthop 22 2-7 Lyons JP, Edwin A, Hoffer MM (1998) Ulnar nerve palsies after percutaneous cross-pinning of supracondylar fractures in children s elbows. J Pediatr Orthop 18 43-45 Lyons ST, Quinn M, Stanitski CL (2000) Neurovascular injuries in type III humeral supracondylar fractures in children. Clin Orthop 376 62-67... 

Fig. 5.34a-g. Calcium pyrophosphate deposition disease, a-c Transverse 12-5 MHz US images obtained over a the femoral trochlea, b the posterior aspect of the medial condyle and c the lateral meniscus in a patient with bilateral degenerative osteoarthritis of the knee reveal scattered hyperechoic foci (arrowheads) due to crystal deposition within the hyaline cartilage, the medial meniscus and the joint capsule (arrows). F, femur T, tibia. Note that crystals tend to be deposited in the middle layer of the cartilage, parallel to the subchondral bone, d-f Radiographic correlation, g Schematic drawing illustrates the typical deposition pattern of pyrophosphate crystals within the cartilage... 

The femorotibial joint consists of two compartments medial and lateral. The medial compartment is composed of the larger medial condyle and the concave superior aspect of the medial tibial plateau and has a wider anteroposterior diameter compared with the lateral one. The lateral compartment is formed by the smaller lateral condyle and the flat or convex articular surface of the lateral tibial plateau. The medial compartment gives stability to... 

On the medial condyle of the tibia and through a fibrous expansion into the lateral femoral condyle. 

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