This report adds six Salter-Harris type-III fractures of the medial
femoral condyle to the fourteen such fractures that have been previously
reported in the English literature. The injury results from a valgus force
applied to the knee. As the fracture may reduce spontaneously, radiographs
may not be diagnostic and the fracture may be unrecognized or be mistaken
for disruption of the medial collateral ligament. If a fracture is
suspected, a cross-table lateral radiograph should be made in an attempt to
detect fat within the joint fluid and confirm the existence of an
intra-articular fracture. An oblique, tunnel (notch), or over-penetrated
radiograph may demonstrate the fracture. However, if it fails to do so,
radiographs made with valgus stress applied to the knee while the patient
is under general anesthesia may be necessary. In our six patients,
satisfactory healing of the fracture occurred after either spontaneous or
manipulative reduction and subsequent non-weight-bearing immobilization in
cylinder cast. Minimum femoral shortening developed in two patients, late
anterior cruciate laxity was demonstrable in two patients, and one patient
required arthrotomy for removal of an osteochondral fracture fragment.