The Hip
Home » Bones » Tibia and Fibula » Medial Condyle Frx in Adult

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.