Severe condylar fracture with rupture of articular apparatus

Causes/features

Diagnosis

Management

Direct blow to tibia from fall from height.
Road traffic accident-High speed injury as le accidents. It involves articular ligaments(tibial and fibular collateral and anterior and posterior cruciate ligaments) and if severe enough, also the lateral and medial menisci. Either abduction or adduction injuries can damage the common peroneal nerve.

Reduce.
For those over 45 years: Immobilize in long plaster cast for 4 weeks.
No weight bearing until 10 weeks
For those above 45 years use a long plaster with crutches. Convert to walking plaster for 8-10 weeks if crutches cannot be used.
For those below 45 years use internal fixation with transverse screw and bolt after elevating depressed fractures, after surgical exposure Remove menisci if ruptured and repair ruptured ligaments. Then immobilize for 6-8 weeks and then mobilize knee. Use crutches without weight bearing for 10-12 weeks after operation.

Severe condylar injury. Click for anatomy


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