Multifragmentary articular fractures characterized by the involvement of both the medial and lateral condyles are classified by the AO/OTA as 41C3 fractures. The metaphyseal part of the fracture may be multifragmentary as well.
They usually result from high-energy injuries. In addition to the bicondylar fragmentation there is metaphyseal comminution with loss of continuity between the proximal epiphysis and the diaphysis.
A major concern in managing these severe injuries is the invariably present severe soft-tissue envelope injury. Treatment of these fractures is difficult and requires careful judgment and technical expertise.
X-ray taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.