Marginal fracture of the medial tibial condyle. Diagnosis and treatment of tibial condyle injuries. Characteristic manifestations and diagnosis

An active lifestyle is the basis of human health. However, excessive and/or inadequate exercise stress entails damage to bones, muscles, and ligaments.

Causes of injury

The condyle is the thickening at the end of a bone to which ligaments and muscles are attached.

It is more fragile as it is covered with cartilage tissue. The causes of injury are:

strong impacts when falling;
car crashes;
unsuccessful leg straightening.

Types and symptoms

By existing classification There are medial and lateral, anterior and posterior, external and internal fractures of the tibial condyle. The characteristics of the affected anatomical region, the presence of bone fragments, and the presence/absence of damage to both condyles are taken into account.

General symptoms include pain and swelling. The injury site is tactilely warmer than the rest of the leg. Distinctive feature with fractures of one condyle – knee deformity. The intensity of pain cannot judge the extent of damage. To clarify the nature of the fracture, X-rays are used, and less often, computed tomography.

Compression fracture

Integrity violation bone tissue associated with compression. Such injuries are a consequence of prolonged exposure to a damaging agent. An intra-articular fracture involves the surface of the tibia and fibula.

Comminuted fracture

Often occurs as a result of car accidents, accompanied by dissection of the bone into fragments that damage the surrounding soft fabrics and vessels. The type of fracture is dangerous due to internal bleeding and is difficult to treat.

To fix bone fragments and make it possible to restore it, an Ilizarov apparatus is used.

Impression fracture

Otherwise called depressed. The blow falls on the area of the intercondylar eminence, which leads to injury. The cause may be a jump from a height.

Consolidated fracture

Damage to bone tissue at the stage of consolidation, that is, restoration. Splicing does not always go smoothly, especially if there are many fragments. Callus is easily exposed and damaged.

Lateral condyle fracture

Most common after surgery car accident and among athletes. An x-ray will show how much the lateral tibial condyle has moved. The fault line will be oblique or vertical. If exposure to the traumatic agent continues, the fragments will move. It is worth resting the injured leg.

External condyle fracture

This type of injury occurs if the knee is bent more than 45° at the time of the accident, as well as in sports and after an accident. X-ray examination of the damage can be done in frontal or lateral projection. If the problem is not visible on standard photographs, and the pain remains, then a fracture of the lateral condyle of the tibia is identified using an oblique projection.

Diagnostics

Symptoms have common features with hip fractures. An x-ray is required to make a correct diagnosis. Consultation with an orthopedic surgeon is required. Clinical picture and history taking are important, but without x-ray It will be very difficult to assess the situation and think through treatment tactics.

A fracture can be visually diagnosed using the following manipulations:

Carefully take the injured limb with your hands and try to bend it at the knee. The patient will feel pain, but the leg will remain motionless.
On a previously immobilized leg, when you try to press your fingers on the patella, it will move unnaturally, causing discomfort.
Tapping the heel and shin will increase the pain.

If the injured area is painful and noticeably swollen, consult a specialist as soon as possible.

Fracture treatment

It is based on two methods: conservative and surgical. Treatment tactics are determined by the patient's condition. Self-reduction is not allowed!

The tactics of health measures depend on the type of fracture:

Without offset: has the most mild course. Pressure bandages are used for a period of 4 to 8 weeks, the dynamics are monitored and it is recommended not to put stress on the leg.
Local compression: take into account the location of the damage, the presence of fragments and associated violations integrity of ligaments. During hospitalization, plaster fixation is used.
Partial avulsion of the condyle: accurate x-ray diagnosis is necessary to determine the position of the bone parts. Plaster immobilization prior to skeletal traction is indicated.
Condylar avulsion: involves avulsion of 8 mm or more. Treatment is surgical.
Chipping: The internal condyle is captured. Open reduction with internal fixation is used.
Comminuted: such fractures imply the presence internal bleeding. Strictly observing the rules of asepsis, the patient is hospitalized for skeletal traction. An x-ray will help understand the location of the fragments.

Conservative methods

Indicated when the condyle is slightly displaced and there are no fragments. Use cold to relieve swelling, pressure bandages, and immobilization of the knee in orthopedic device. Displacement of fragments is prevented by a plaster cast. Loads on the leg are contraindicated.

Surgical methods

In more severe cases, it is used to treat a fracture of the condyle of the knee joint. surgical methods treatment.

open and closed reduction;
osteosynthesis;
securing the fragments using the Ilizarov apparatus.

Any treatment method requires inpatient observation.

Rehabilitation

During the period of fusion, the resulting callus is highly susceptible to external factors and can be easily damaged. The doctor ensures that the medial and lateral edges of the articular surface are restored equally. To speed up the process use:

inclusion of foods containing calcium in the diet;
resumption of movements in the knee joint;
limiting the load on the injured leg;
physiotherapeutic procedures to prevent the development of dystrophy;
rubbing and therapeutic massage.

In addition to well-known dairy products, a lot of calcium is found in cabbage, sorrel, fish and almonds.

Complications

After damage to the tibia, there is a high risk of encountering the following consequences:

complete or partial loss of movement in the area of the fracture;
development of degenerative arthrosis;
deformity of the knee joint;
damage to ligaments by bone fragments;
surgical treatment complicated by infection.

Prevention of fractures

It is important to take care of nutrition, your own safety, and choose the right clothes.

In order for calcium to be absorbed by the body and not washed out of the bones, vitamin D must be supplied in sufficient quantities. Daily norm for an adult – 600 IU.

Choose clothes according to the season. Slippery autumn boots in icy winter conditions are far from the best choice.

Moderate physical activity will strengthen muscles and ligaments, creating natural protection for inert tissue. Walking on crutches (during the rehabilitation period) will help to correctly distribute the load on the limb.

A fracture of the tibial condyle (with or without displacement) is an unpleasant phenomenon. However, correctly chosen treatment tactics and adequate rehabilitation will help avoid possible complications.

Limb fractures are among the most common. Their number especially increases in winter, when icing appears on sidewalks, which in our country are reluctant to clean. Some of the most severe injuries are injuries to the articular surfaces; they bring a lot of trouble, take a very long time to heal and heal rather poorly. When diagnosing problems of this kind, a person’s limb can be put in plaster for a long time.

One of the most common leg injuries is a tibial condyle fracture. It can be either impression (intra-articular) or compression. Problems of this kind are especially common in people who have fallen from a height (for example, from a ladder, from a tree, or even from a window), while their legs should be in an extended position. Today we’ll talk about how troubles of this kind are treated, how long they take to heal, and how rehabilitation after an injury proceeds.

What is this injury?

The condyle is a thickening at the end of a bone to which muscles and ligaments are attached. There are two of them on the tibia:

Medial (internal).
Lateral (external).

The condyles are a rather fragile part of the bone, because, unlike the bone itself, they are covered with cartilage tissue. It is more elastic and much less resistant to all kinds of damage.

As we said above, the cause of injuries of this kind are falls from a height and landing on straight legs. If something like this is noted, the condyles are strongly compressed and the dense part of the metaphysis is pressed into the spongy substance of the epiphysis. Ultimately, the epiphysis is divided into two parts, due to which the external and internal condyles are simply broken. A fracture may appear to occur in two of the specified parts of the joint, or in just one. You can distinguish them by one simple sign:

if the tibia moves outward, there are problems with the external condyle;

if the tibia moves inward, the internal condyle is broken.

The classification of injuries of this kind is quite extensive. First of all, complete and incomplete injuries are distinguished. In the first case, complete or partial separation of the condyle is noted. If the fracture is incomplete, then cracks and indentation may be noted, but separation is not observed. In total, injuries are divided into two large groups:

Fractures without displacement.

Displaced fractures.

Condyle injuries are often diagnosed with a number of associated injuries. These include injury to the fibula, ruptures or tears of the knee ligaments, menisci, and fractures of the intercondylar eminence.

Characteristic manifestations and diagnosis

It is not difficult to identify fractures of this kind. First of all, the specialist will pay attention to characteristic symptoms injuries, which include:

soreness;

hemoarthrosis;

dysfunction of the joint;

deformation characteristic of such injuries;

lateral movements in the knee joint.

It should be noted that the pain associated with condylar fractures may not correspond to the complexity of the injury. Therefore, when diagnosing a problem, palpation is performed - feeling the area of damage. Experts do this in order to determine painful sensations at specific points. Moreover, you can find out the nature of the injury yourself. It is enough to just apply light pressure on the knee joint area. If you feel discomfort, then you need to urgently visit the nearest medical facility.
One more characteristic feature injuries of this kind is hemoarthrosis, which can reach quite large sizes. The essence of this problem is the increase in volume of the joint, which causes circulatory problems. If something like this is noted, the specialist will have to urgently refer the patient for a puncture. This procedure will help remove accumulated blood.

You can also determine the damage yourself by gently tapping your fingers along the axis of the shin. If you feel severe pain, it means that the condyles are most likely broken. Any movement in the injured knee will be accompanied by severe pain. Finding a position that brings relief is very difficult. If you try to change the position of your leg, you will immediately feel a new attack of pain.

IN medical institution specialists perform radiography in two projections. The photographs will help determine the presence of damage, as well as assess its nature and complexity. If a displacement injury occurs, the specialist will be able to see how far the debris has shifted.

Fracture treatment

Let us immediately clarify that treatment of fractures of this kind is carried out directly in a medical institution. If a displaced injury is diagnosed, the patient is referred for a puncture, which is necessary to remove blood that has entered the joint. Once the procedure is performed, firm fixation of the injured limb is required. Plastering is performed over the entire surface of the leg, starting from the toes and ending with the gluteal fold. For some time, the patient is strictly prohibited from any load on the injured limb.

During the restoration of a limb after a fracture, they are used various methods. Let's look at the main ones.

Realignment of the leg. It will be necessary to restore the alignment of the condyles in the glenoid sockets.

Strong fixation. About this method we mentioned a little higher. The leg is in a cast until the injury heals. Duration of treatment in in this case sometimes very different.

In some cases, specialists may prescribe early loading on the damaged joint. In this case, the plaster will be removed, and the patient will need to carefully bend and straighten the knee.

It is impossible to unambiguously describe treatment tactics for injuries of this kind. Injuries can be different, so the approach in each case may be different. Specialists choose a method of dealing with injury depending on its complexity and type. So, if an incomplete fracture or damage of lesser severity is noted, the limb is fixed in a cast for a period of 21-30 days. As mentioned above, fixation is carried out from the upper thigh to the fingertips.

During treatment, the patient is strictly forbidden to walk even on crutches. The latter can be permitted no earlier than after the leg fixation period has expired. Specialists are also able to use traction or immediate reduction.

For more severe cases surgical intervention is used. If a displaced fracture is noted, the doctor will need to collect the fragments and set them in place. In this case, the length of time patients stay in a cast can greatly increase. Refusing to fix the leg until the damaged area of the leg has completely healed is strictly prohibited.

A fracture of the tibial condyle is a very serious and serious injury. It is impossible to give an unambiguous time frame for recovery in this case. Additional measures, including rehabilitation, are prescribed exclusively by a specialist.

A fracture of the condyle of the knee joint is enough to require treatment. The knee joint is one of the most complex and large joints human body, also, he is the most vulnerable to injury. The most common type of injury in the knee joint is a fracture of the tibial or femoral condyles. Damage to the bone tissue of the joint refers to severe injuries, the treatment and correction of which requires effort, serious attitude and long-term rehabilitation.

Mechanisms and types of fractures

Understanding the mechanisms of injury is necessary for the diagnosis and treatment of injury. Fractures of the condyles of the knee joint occur in the following situations:

Direct blows applied to the outer surface of the joint in a bent or extended state, such injuries often occur in car accidents.
A fall with landing on a limb bent at the knee, the lateral and straight surfaces of the joint.
Falling with straight legs.
Forced deflections or rotations of the lower leg also lead to such injuries.

Such injuries occur frequently in life and, as a rule, lead to combined injuries, with damage to several at once. bone structures, ligament ruptures, chondromalacia or osteochondritis dissecans.

For reference! The complexity of the structure of the joint and the variety of mechanisms of injury determine the variety of fractures, so you can find many classifications and types of condyle fractures femur or tibial, but the following injuries are clinically important.

Fracture of the condyle of the knee joint without displacement

Characterized by a crack, a defect in the bone tissue. This type of fracture is treated by immobilization in a plaster cast for several weeks, full recovery occurs in 3-4 months.

Compression fractures of the tibial condyles

Occur by crushing against the condyle of the femur. This type of fracture is characterized by relative preservation of integrity synovial membrane, which does not provide grounds for the development of arthritis. Also, with this fracture there is less severe damage ligamentous apparatus. The prognosis in this case is good, and if you seek help in a timely manner, surgical intervention can be avoided.

Restoration of the level of the displaced and depressed condyle is achieved through manual reposition and subsequent fixation on the table with traction or a normally applied plaster cast. Thus, wedging and fixation of the fragment in the knee joint occurs.

As an example, a fracture of the lateral condyle of the tibia. There is a characteristic separation of a large fragment of the condyle, with its deviation, displacement to the outside by several mm, and fragmentation of the articular surface of the bone is also observed. This type of fracture is caused by a slightly different position of the femur at the time of injury.

As a result strong blow the femur touches the articular surface of the tibia and wedging occurs and the condyle splits. Typically, with this type of fracture of the lateral condyle of the tibia, the application of force occurs in a small area; as a result, the head of the fibula is not injured, but is separated along with the broken fragment of the tibial condyle by several mm.

The severity in this case may vary, depending on the degree of damage to the ligaments and blood vessels. But usually there are complete ruptures of the ligaments, severe damage to the menisci, which can be pressed into the tibial surface.

The cartilaginous base of the joint is damaged, which leads to arthritis and chondromalacia.
Damage to the vessels supplying the joint leads to insufficient blood supply to the articular structures, which is why tissue necrosis subsequently occurs; this can result, for example, in osteochondritis dissecans. Predictions in this case are made carefully.

Treatment and restoration in this case also involves returning the broken fragment to its anatomical position. This is also achieved different ways and depends on the severity of the fracture, which is being judged. In some cases, they are limited to manual reposition, but, as a rule, this is not enough. Then surgical reposition is indicated, and, if necessary, arthroplasty of the damaged structures.

Fractures of the lateral and medial femoral condyles

Possible with forced abduction and adduction of the lower leg that goes beyond the anatomical framework, as well as with a fall on outstretched legs. Fractures of the lateral and medial condyle knee joint - this is also the breaking off of a fragment or the entire condyle with a displacement of 3 mm or more, or without it. Osteochondritis dissecans is also a complication.

Chondromalacia is a pathology of cartilage tissue in which depletion, thinning and destruction occur. With osteochondritis dissecans, detachment of a section of cartilage tissue from the bone is observed.

Important! Whatever the type of fracture, its treatment should take place in a hospital, by doctors, since it depends on the time of treatment, the doctor’s literacy and proper treatment depends on its success and the elimination of complications.

Symptoms appear almost immediately after a fracture, and they will help determine the type and complexity of the damage:

the appearance of a characteristic pain syndrome, localized in the joint and hip;
instability, excessive mobility of the patella;
feeling of instability, vibrations in the knee;
upon palpation, pressing on the broken condyle of the knee joint, severe sharp pain appears;
limitation and severe pain in movements in the joint;
a characteristic crunch, also known as crepitation, upon palpation, is caused by the presence of movable bone fragments;
there will be swelling and swelling of the knee area, effusion in the joint cavity, which smoothes the outline of the joint.

Often, despite the presence of a fracture, patients successfully move on their own, and do not immediately consult a doctor, because it happens that there is no knee pain after an injury and a fracture.

Important! If there is a suspicion of a fracture, the presence of characteristic symptoms, or a previous injury, you should immediately consult a doctor, because sometimes there may be no pain. Failure to see a doctor in a timely manner may lead to the need for surgical intervention, which can be avoided if the fracture is fresh.

The doctor performs an external examination and based on the results x-ray examination in the required projections, determines the severity of the fracture and subsequent treatment.

Treatment

The treatment process is fundamentally different for patients with displaced and non-displaced fractures.

The first step in case of a fracture without displacement of the fragments is a puncture, through which the effusion and blood located in the joint cavity are removed. After this, a small amount of novocaine solution is injected into the joint cavity, then the joint needs to be immobilized with a plaster cast. Having previously bent the knee joint by 5-10 degrees, the limb is immobilized with a plaster cast.

The application period is about 2-3 months, after which classes are necessary for rehabilitation physical therapy. It is important for the rehabilitation period to start training the thigh muscles. This is done literally 2-3 days after applying the bandage by raising the limb. Later, after about 7 to 10 days, movement on crutches is allowed; it is very important that there is no load on the joint.

Therapeutic measures for fractures with displacement of bone fragments may be different, but initially reposition is required, the return of displaced structures to their normal state:

Having determined the severity and type of fracture, the specialist performs manual reduction under anesthesia, fixes top part limbs, manipulating the lower. After which an immobilizing agent is applied gypsum bandage for the required period.
The doctor may also decide to treat with constant traction if the fragment is displaced by more than 3 mm. This involves slowly reducing the fragments by applying a special splint to the limb and using a weight system. After a few weeks, if the reduction is successful, the traction system is changed to a plaster cast.

If, conservative methods do not give the desired effect or the fracture is quite complex, surgery is prescribed. Displaced fragments are fixed with bolts during the operation, and fusion also occurs long time, after which the screwed in bolts are removed.

Limb injuries are especially common in winter - due to icing, the number of unsuccessful falls increases sharply. Joint injuries are the most severe. Bringing a lot of inconvenience, they are difficult to cure and take a long time to heal.

A fracture of the tibial condyle, compression or impression (inside the joint) is one of the most common. It can happen when the victim falls with straightened limbs or under other circumstances.

Fracture of the condyles of the tibia - damage to the thickening at its end. This is where the ligaments and muscles attach. There are two of them - internal (medial) and external (lateral). The condyles are quite fragile because they are covered with cartilage. This tissue differs from bone elasticity; it is not so resistant to external influences.

Comminuted fracture the condyle of the tibia is a consequence of its displacement. When a person falls, they are sharply compressed. A dense layer of metaphysis is pressed into the epiphyseal spongy composition. The epiphysis divides into a pair of parts, breaking the condyles.

You can determine which part is broken by external signs:

the tibia moved outward - a fracture of the internal condyle of the tibia occurred due to displacement;
The shin moved inward - the internal condyle was damaged.

Complete fractures are also identified when the condyle is separated. When not quite complete fracture probably indentation or cracks - but no separation. Also, a fracture of the fibula or tibia with an affected condyle can be with or without displacement.

Often such injuries are accompanied by accompanying troubles:

injury to the fibular bone;
ligamentous and meniscal tears, tears;
fractures of the elevation between the condyles.

Symptoms and diagnosis

Fractures of the tibial condyles have characteristic symptoms:

pain;
disorders of joint functioning;
hemoarthrosis;
specific deformation;
lateral movements of the knee joint.

Pain does not always depend on the severity of the injury. A displaced fracture of the lateral condyle of the tibia may not be felt. Therefore, the damaged area should be probed by a specialist. This is how the doctor determines the presence of pain in certain points. You can simply apply pressure on the knee joint yourself. If the sensations are unpleasant, it is better to visit a traumatologist.

Hemoarthrosis, sometimes reaching significant sizes, is also characteristic of such injuries. The fact is that the joint increases in volume, thereby disrupting blood circulation. In this case, the doctor sends the victim for a puncture, which involves getting rid of accumulated blood.

Suspicions of a fracture of the medial or lateral condyle of the tibia may also appear after tapping the axis of the tibia with the fingers. If the pain is severe, then they are most likely broken. It will be very painful every time you move the affected knee. It’s not easy to find a position in which it will be easier. Any change in the position of the leg leads to new pain attacks.

Treatment

A fracture of the condyles or intercondylar eminence of the tibia is treated, taking into account the specifics of the injury. First, the fragments are set - if there are any. Then they are fixed until total consolidation occurs. An ice bag is applied to the limb.

If there is a crack or incomplete fracture of the internal or external condyle of the tibia, plaster splints provide immobilization - from the upper third of the thigh to the fingers. It is placed for a month.

In the hospital, traction is done, either adhesive or skeletal, as well as simultaneous manual reduction, then fixed with constant traction. When it doesn't happen big fracture The condyle of the tibia with concomitant displacement is pulled by the tibia using the adhesive method. A pair of repositioning side loops is used.

At marginal fracture of the external condyle of the tibia, the lateral loop is installed so as to direct the traction outward from the inside. This eliminates the typical deformity, and the displaced condyle is reduced and held in place. correct position.

If a fracture causes severe displacement, subluxation or dislocation of one or both condyles, skeletal traction has to be performed. An ankle clamp is used for this.

To bring condyles that have moved to the sides closer to one another, the N.P. system apparatus is suitable. Novachenko or side loops. Sometimes you have to manually set the displaced fragments. Pain relief used:

on the spot;
into the spinal cord;
general.

In the case of using traction, in the absence acute pain You can move on to intense movements after just a few days. Early activity helps to achieve better reduction of fragments and create congruence of joint surfaces.

Adhesive, as well as skeletal, traction is usually eliminated a month after installation. After the skeletal procedure, additional adhesive traction is placed for half a month. When the traction is completely removed, the victim can get to his feet without putting much strain on the injured leg. It will be possible to fully activate it no earlier than in another month.

Surgery

The operation must be performed if:

Reduction of the fragments did not help;
closed reduction with further traction did not help;
a fragment is pinched inside the joint;
there is a fracture between the condyles;
fragments are compressed brightly;
vessels and nerves were pinched.

Even skeletal traction, which usually provides the best comparison of fragments, does not always help. As a result, there are more indications for surgery, and doctors give this recommendation to victims more often.

If the lesions are fresh, an arthrotomy is performed. In this case, the smallest particles present in the joint are completely removed, and large ones are subjected to fixation:

cloves;
knitting needles;
screw;
special plates for support.

For open fractures or with multiple fragments, external osteosynthesis is performed using an Ilizarov apparatus. The Sitenko osteoplastic procedure is performed if:

outdated closed fracture internal or external condyle;
subsidence of the condyles is secondary, due to intense load on the injured leg;
fresh injury with high compression.

The joint is opened and then an osteotomy is performed. As a result, the upper part of the affected condyle rises to the height of the second condyle. The joint areas must be in a single plane. The resulting void is filled with a wedge. It is prepared in advance from bone - auto- or heterogeneous. The collected fragments are fixed with a plate and screws.

Then the wound is sutured and drained. After the operation, immobilization is carried out. The drainage is removed after three to five days.

It is necessary to perform exercise therapy based on passive exercises to prevent joint contracture. Shown thermal procedures. When the pain subsides, you can work on the affected joint.

After conventional osteosynthesis, light axial loading is allowed three months later, after bone grafting - after four months. You will be able to fully rely on your limb in five months. The results of treatment will be positive if it is carried out correctly and the patient follows all the doctor’s recommendations.

Complications

Compression or non-compression fracture of the tibial condyle requires a competent approach to treatment and following the recommendations. Diagnosis of fractures and intervention by doctors is carried out as early as possible. Experienced doctors should deal with trauma.

Otherwise, serious consequences are possible:

long-term immobilization;
degenerative arthrosis;
angular deformities of the limb;
infection of the wound during surgery.

When the lateral part of the apex of the bone, called the tibia, is damaged, a fracture of the tibial condyle is inevitable. This type of injury is considered an intra-articular fracture, which occurs after a direct blow or a sharp fall on knee-joint or on a straight leg.

Often such damage is accompanied by indentation of small bone fragments or displacement. The main manifestation of a fracture is limitation of movements, sharp pains, hemarthrosis. The support is impaired, the knee joint moves poorly.

A fracture of the tibial condyle occurs as a result of a traumatic action of great force. As a rule, compression is performed with rotation along the axis. More than half of the fractures of this type occurs as a consequence of an accident. Only a fifth of cases occur from falls from height. The type of injury is directly proportional to the fixation of the leg at the time of injury. Damage to the lateral condyle is possible when the leg is abducted to the side at the time of injury.

When the knee is extended, an anterior fracture occurs. In addition, a fracture of the tibial condyles can occur for a number of reasons, including diseases of the musculoskeletal system.

Classification

External or external (lateral);
Internal (medial).

As a rule, a bone thickening is a fragile part, since its covering is only cartilage tissue, which has good elasticity, but at the same time it has poor resistance to damage. The most common predisposing factors that accurately predict a fracture of the intercondylar eminence of the tibia are straight legs when falling from a great height.

In such a deplorable case, strong compression of the condyles and subsequent division of the epiphysis into several parts is inevitable. The internal and external thickening of the bone is broken. There are several main types of fracture, strictly depending on the part of the joint:

An outwardly displaced shin implies a fracture of the lateral condyle of the tibia or various kinds of problems with it;
Shifted to inner side tibia results in a fracture of the medial condyle.

A broad classification is inherent in injuries of this type. Incomplete and complete damage should be distinguished. With the latter, partial or complete separation of part of the condyle is observed. With incomplete damage, in the vast majority of cases, cracks and indentation are noted, but without separation.

There are two main groups of injuries:

With offset;
No offset.

Typically, damage to the condyles is accompanied by a number of other injuries, as diagnostics show. Along with the condyle, the fibula is injured, a tear or complete rupture occurs knee ligaments, the intercondylar eminence and menisci break.

Symptoms

These fractures are easily identified. Specialists initially carefully study the characteristic symptoms of damage:

It happens that the pain accompanying a fracture of the medial condyle of the tibia is completely inconsistent with the complexity of the injury. In this case, it is important to carefully feel the area of damage (palpate the leg). It is important for the specialist what sensations the victim will experience during the process of applying force to specific points.

It is easy to find out the nature of the fracture yourself by pressing just a little on or near the knee joint. Unpleasant sensations will indicate the need for an urgent visit to a medical facility.

The injury is characterized by such a sign as hemarthrosis, reaching big size. The joint can increase noticeably in volume, because proper blood circulation is disrupted.

Having noted this, a specialist in mandatory directs the patient to perform a puncture. Puncture – best procedure to remove blood accumulated in joint tissues.

First aid

If you have sustained a fracture of the lateral tibial condyle or any other fracture, the injury should be diagnosed immediately and appropriate treatment initiated. First first aid will help the patient wait for qualified specialists to arrive if he is unable to get to the hospital himself. First aid includes:

Call an ambulance and check the list with a specialist necessary medications, approved for use by victims for the purpose of relieving pain;
Anesthesia of the damaged area using analgesic drugs;
Treating the edges of the wound with an antiseptic; if the wound is open and there is noticeable bone displacement, a mandatory step is to cover the wound with sterile bandages, but tight bandages should not be used;
Plugging with a sterile cloth will help stop the bleeding in the first couple of days.

If there is no displacement, you need to fix the leg by immobilizing the limb and applying a special splint made from nearby materials.

Diagnostics

X-ray of the joint is considered the only way instrumental diagnostics when there is a fracture of the internal condyle of the tibia or another. The photograph must be in two projections - this is a prerequisite. Thanks to this, it is possible to establish with exact certainty the fact of damage and the nature of the displacement of the fragments.

If the X-ray results are too ambiguous, a CT scan of the joint may be additionally prescribed. When a doctor suspects meniscus or ligament damage, he may order an MRI of the knee.

Neurosurgeons may be involved when there is reason to suspect damage nerve bundle or vessels.

Treatment

If you have received a fracture of the tibial condyle, the treatment period for which is approximately 4 weeks, rest assured that full functionality of the limb will return no earlier than four months later. Treatment is often carried out conservatively, but it can be difficult to do without surgical intervention.

A closed fracture without displacement means that it is important to fix the limb very quickly to ensure that late displacement of the fragments is avoided. A plaster splint up to the fingertips is the best option.

Three months after the injury, it is allowed to perform minimal loads so that the condyle of the bone does not settle. The leg is developed at 4 months, physiotherapy and massages are prescribed. When breaking the external or internal condyle causing displacement, be prepared for reduction before fixation. After removing the plaster splint, the leg is re-examined using x-rays.

Successful fusion of the bones means that a further plaster cast will be applied for 4 weeks.

Surgical treatment

When there is an impression fracture of the area in question, a comminuted fracture or displacement, surgery cannot be avoided. Using open reduction, the doctor compares the fragments. Screws, bolts and pins secure the debris before applying plaster. Recovery takes much longer in this case.

Rehabilitation period

Rehabilitation takes a very long time. It may take almost six months to recover and return to in a full way life. Recovery process begins exactly when the plaster cast is removed.

The rehabilitation specialist determines the necessary set of recovery measures.

Complications

Usually, satisfactory prognosis can be achieved if all medical recommendations are correctly followed. Premature loads provoke subsidence of one of the fragments, which can result in the development of limb deformity and progression of arthrosis. Possible complications:

Arthrosis;
A loss motor function knee;
Nerve damage;
Infectious infection with an open fracture;
Angular deformity of the joint;
Joint instability.

Timely initiation of treatment in full compliance with medical instructions will help to avoid any disappointing consequences and restore the activity of the limb in all cases.

Modern medicine can help you choose the most suitable method highly effective treatment of condylar fractures.