0:01

A chondral fracture is defined as a fracture isolated

0:05

to articular cartilage that does not extend

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through the subc chondral bone plate.

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Here's the example I showed you before.

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This is a chondral fracture

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manifest from an osteochondral injury leading

0:22

to a chondral defect, full thickness

0:26

measuring whatever with sharp margins,

0:30

indicating a traumatic etiology

0:33

with an intact subc chondral bone plate

0:35

and a sub bone contusion.

0:38

That's the description

0:40

that I would use looking at this particular finding.

0:44

How about this one here?

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This is, uh, after the injury, not too far along.

0:51

This is a chondral injury. There's no light bulb.

0:54

This is a chondral injury manifest as a chondral fracture

0:59

leading to a chondral defect.

1:02

Full thickness measuring whatever

1:06

with an intact subc chondral bone plate, no sub

1:11

bone bruise or contusion,

1:13

and with relatively sharp margins indicating

1:18

a traumatic event.

1:19

That is how I would describe this particular problem.

1:24

Now, you can get cartilage abnormalities

1:27

from degenerative conditions,

1:29

but usually rather than having sharp margins,

1:33

you're gonna see gradual sloping margins at the periphery.

1:38

As in this example with involvement mainly of the troia,

1:44

an osteochondral fracture defined

1:48

as a fracture that extends through the articular cartilage

1:53

violates the subc chondral bone plate

1:56

and extends as a fracture line into the subc chondral bone

2:01

generally in a continuous fashion.

2:04

I'm showing you some examples with a picture on your right.

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I want to show you an example.

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This is one of my favorite fractures.

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This has a name, it's called a hoffa's fracture.

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This is an isolated coronal fracture generally

2:19

of a single condyle, usually the lateral femoral condyle.

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Here. These two image shows you the, the, uh,

2:28

coronal fracture orientation

2:31

and I can tell you often on radiographs

2:33

because the opposite condyle is not involved.

2:37

You can miss this on the radiographs.

2:39

This is a beautiful example of what a Hoffa

2:43

osteochondral fracture looks like.

2:47

And as we mentioned earlier on, I think two other occasions,

2:51

we see classic osteochondral fractures associated

2:55

with ACL disruption around the knee

2:58

Once more, the deep notch, we know measurements for that.

3:03

The long notch. We don't have measurements for that.

3:07

The double notch in the lateral femoral condyle

3:11

seen in the immature skeleton more often with the

3:14

fracture being the more posterior defect.

3:18

Right, and this being the normal lateral con

3:22

patella sulcus.

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And as we were talking about earlier, it always seems

3:26

to me this is a little bit further anter

3:30

when you have the double notch.

3:31

I don't quite understand that.

3:33

So maybe one of our, uh, fellows

3:36

or a faculty member can investigate why that is.

3:40

And I showed you also this, the osteochondral fracture

3:44

that occurs on the posterior aspect

3:46

of the lateral tibial plateau, the wrinkled tibia.

3:50

So here's a small table

3:53

osteochondral fracture on your left chondral,

3:56

fracture on your right difference with regard

3:59

to the age at which we usually see this, the

4:03

constituents of the effusion, fat

4:06

and blood with an osteochondral fracture, whether

4:09

or not we see it radiographically

4:12

and note here, a better healing potential when the bone is

4:16

involved as opposed to a chondral fracture.