Slide 126 — T condylar fracture

Clean FRCS notes with inline figures

T condylar fracture

•Beware if supracondylar fracture in >10yo

Pathoanatomy:

•Rotatory deformity due to muscle pull

•Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity

Xray:

•Difficult to distinguish from supracondylar fracture

Management

•I undisplaced

•K wires (1x intercondylar, 2x lateral divergent)

•II displaced (>2mm), metaphysis intact

•OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)

•Articular congruity restored by screw fixation

•Supracondylar fixation by K wire

•III displaced + metaphyseal comminution

•OR

•Articular congruity restored with screw

•Supracondylar stabilization with plate + BG

Complication

•Stiffness

•Trochlear AVN

Direct Q&A

Q1 What anatomy is relevant to T condylar fracture?

Rotatory deformity due to muscle pull

•Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity

Q2 What are the radiographic findings for T condylar fracture?

Difficult to distinguish from supracondylar fracture

Q3 How is T condylar fracture managed?

•I undisplaced

•K wires (1x intercondylar, 2x lateral divergent)

•II displaced (>2mm), metaphysis intact

•OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)

•Articular congruity restored by screw fixation

•Supracondylar fixation by K wire

•III displaced + metaphyseal comminution

•OR

•Articular congruity restored with screw

•Supracondylar stabilization with plate + BG

Q4 What complications are listed for T condylar fracture?

Stiffness

•Trochlear AVN

Raw speaker-note hierarchy audit

#	marL	indent	logical	original note line
1	None	None	0	T condylar fracture
2	None	None	0	Beware if supracondylar fracture in >10yo
3	None	None	0	Pathoanatomy:
4	171450	-171450	1	Rotatory deformity due to muscle pull
5	171450	-171450	1	Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity
6	0	0	0	Xray:
7	0	0	0	Difficult to distinguish from supracondylar fracture
8	0	0	0	Mx:
9	0	0	0	I undisplaced
10	0	0	0	K wires (1x intercondylar, 2x lateral divergent)
11	0	0	0	II displaced (>2mm), metaphysis intact
12	0	0	0	OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)
13	0	0	0	Articular congruity restored by screw fixation
14	0	0	0	Supracondylar fixation by K wire
15	0	0	0	III displaced + metaphyseal comminution
16	0	0	0	OR
17	0	0	0	Articular congruity restored with screw
18	0	0	0	Supracondylar stabilization with plate + BG
19	0	0	0	Complication
20	171450	-171450	1	Stiffness
21	171450	-171450	1	Trochlear AVN

lvl

marL

indent

logical

original note line

None

T condylar fracture

None

Beware if supracondylar fracture in >10yo

None

Pathoanatomy:

171450

-171450

Rotatory deformity due to muscle pull

171450

-171450

Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity

Xray:

Difficult to distinguish from supracondylar fracture

Mx:

I undisplaced

K wires (1x intercondylar, 2x lateral divergent)

II displaced (>2mm), metaphysis intact

OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)

Articular congruity restored by screw fixation

Supracondylar fixation by K wire

III displaced + metaphyseal comminution

Articular congruity restored with screw

Supracondylar stabilization with plate + BG

Complication

171450

-171450

Stiffness

171450

-171450

Trochlear AVN

Improved semantic hierarchy used for the study notes

#	semantic level	section?	rewritten line
1	0		T condylar fracture
2	1		Beware if supracondylar fracture in >10yo
3	0	yes	Pathoanatomy:
4	1		Rotatory deformity due to muscle pull
5	1		Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity
6	0	yes	Xray:
7	1		Difficult to distinguish from supracondylar fracture
8	0	yes	Management
9	1		I undisplaced
10	1		K wires (1x intercondylar, 2x lateral divergent)
11	1		II displaced (>2mm), metaphysis intact
12	1		OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)
13	1		Articular congruity restored by screw fixation
14	1		Supracondylar fixation by K wire
15	1		III displaced + metaphyseal comminution
16	1		OR
17	1		Articular congruity restored with screw
18	1		Supracondylar stabilization with plate + BG
19	0	yes	Complication
20	1		Stiffness
21	1		Trochlear AVN

semantic level

section?

rewritten line

T condylar fracture

Beware if supracondylar fracture in >10yo

yes

Pathoanatomy:

Rotatory deformity due to muscle pull

Relatively intact articular surface compared with osseous displacement due to large cartilaginous component of articular surface conferring to more elasticity

yes

Xray:

Difficult to distinguish from supracondylar fracture

yes

Management

I undisplaced

K wires (1x intercondylar, 2x lateral divergent)

II displaced (>2mm), metaphysis intact

OR (paratricipital, TRAP (The triceps-reflecting anconeus pedicle), Bryan Morrey)

Articular congruity restored by screw fixation

Supracondylar fixation by K wire

III displaced + metaphyseal comminution

Articular congruity restored with screw

Supracondylar stabilization with plate + BG

yes

Complication

Stiffness

Trochlear AVN

126. T condylar fracture

Clean FRCS notes with inline figures

T condylar fracture

Pathoanatomy:

Xray:

Management

Complication

Direct Q&A

Rotatory deformity due to muscle pull

Difficult to distinguish from supracondylar fracture

Stiffness

Raw speaker-note hierarchy audit

Improved semantic hierarchy used for the study notes