These fractures are characterized by a simple articular split in association with a multifragmentary metaphyseal component.
They are seen both in the young individual and in the osteoporotic elderly patient.
The patella may commonly obscure a minimally displaced articular split. For this reason, if there is ever a question if a split is present, oblique radiographs or CT scans are helpful.
In decision making regarding treatment of this fracture, generally the surgeon elects to bridge, or span, the comminution in the metaphyseal region after anatomical reconstruction of the articular condylar mass.
1. With an intact wedge
With an intact wedge
The wedge may be medial or lateral.
2. With a fragmentary wedge
With a fragmentary wedge
The wedge may be medial or lateral
X-ray by courtesy of Spital Davos, Switzerland, Dr C Ryf and Dr A Leumann.
3. Multifragmentary metaphyseal
X-ray taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.