C Braune1, S Rehart, F Kerschbaumer, A Jäger. 1. Abteilung für Allgemeine Orthopädie und Traumatologie der Orthopädischen Universitätsklinik Frankfurt. c.braune@em.uni-frankfurt.de
Abstract
AIM: Intraarticular osteochondral fractures resulting from traumatic patellar dislocation in children are reported most frequently between 13 and 15 years of age. Fracture localization concerns, apart from loose intraarticular bodies, the inferiomedial patellar facet and the lateral femoral condyle. Osteochondral fractures of the lateral femoral condyle with more than 50 % of its surface are extremely rare and reported infrequently. METHOD: We report a traumatic patellar dislocation in a 14 year old patient that let to an osteochondral fracture of the lateral femoral condyle. MRI-scan demonstrated an extensive fracture size concerning more than 50 % of the condylar surface with intraarticular dislocation. Initially arthroscopic surgery followed an open reduction and internal refixation of the osteochondral fragment with resorbable, poly-p-dioxanon pins. RESULTS: Follow-up MRI-scan revealed 7 weeks after surgery an adequate repositioning of the fragment with correct pin placement. Second-look arthroscopy demonstrated an osteochondral reintegration of the fragment within a period of 7 months after prior surgery. CONCLUSION: Resorbable poly-p-dioxanon pins as a mean for refixation of an osteochondral, intraarticular fracture in an adolescent, with an arthroscopic confirmed acceptable result, seem to be a considerable therapy option.
AIM: Intraarticular osteochondral fractures resulting from traumatic patellar dislocation in children are reported most frequently between 13 and 15 years of age. Fracture localization concerns, apart from loose intraarticular bodies, the inferiomedial patellar facet and the lateral femoral condyle. Osteochondral fractures of the lateral femoral condyle with more than 50 % of its surface are extremely rare and reported infrequently. METHOD: We report a traumatic patellar dislocation in a 14 year old patient that let to an osteochondral fracture of the lateral femoral condyle. MRI-scan demonstrated an extensive fracture size concerning more than 50 % of the condylar surface with intraarticular dislocation. Initially arthroscopic surgery followed an open reduction and internal refixation of the osteochondral fragment with resorbable, poly-p-dioxanon pins. RESULTS: Follow-up MRI-scan revealed 7 weeks after surgery an adequate repositioning of the fragment with correct pin placement. Second-look arthroscopy demonstrated an osteochondral reintegration of the fragment within a period of 7 months after prior surgery. CONCLUSION: Resorbable poly-p-dioxanon pins as a mean for refixation of an osteochondral, intraarticular fracture in an adolescent, with an arthroscopic confirmed acceptable result, seem to be a considerable therapy option.