Medial Condyle Frx in Adult 



- See: Medial Approach:

- Discussion:
    - medial epicondyle is common origin of several flexor muscles of hand and wrist;
    - when medial epicondyle is frxed, flexor muscles pull fragment distally;
    - during surgical procedure care must be made to protect ulnar nerve;

- Fixation Stratedgy:
    - medially directed plate fixation takes advantage of avoiding ulnar nerve, except when the distal plate screw extends over the distal-medial
          portion of the condyle;
    -  w/ low medial column frx, a 1/3 tubular plate may be contoured around the medial condyle, which allows insertion of a interfragmentary 
          lag screw,
          directed superiorly in the medial column (avoid the fossa);
          - as mentioned, a plate placed over the distal-medial edge of the condyle will encroach on the cubital tunnel and may irritate the 
                ulnar nerve;
                - in these patients, anterior transposition may indicated;
    - implants:
          - 4.0 cancellous bone screws, 3.5 mm cortex screws, or 4.5 mm canulated screws as lag screws;
          - one third tubular plate may be necessary for larger fragments;
    - technique:
          - contour a 3.5-millimeter reconstruction plates to the medial epicondyle;
          - the reconstruction plate is contoured and bent around to cradle the epicondyle;
          - most distal screws are directed into medial epicondyle;
          - ulnar nerve in condylar fractures:
                - note that a plate or lag screw placed over the distal-medial edge of the condyle will encroach on the cubital tunnel and may 
                       irritate the ulnar nerve;
                - in these patients, anterior transposition may indicated



Fracture of the medial condyle of the humerus.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, May 30, 2012 10:00 am