Adolescent patellar osteochondral fracture following patellar dislocation

Lee, Byung J.; Christino, Melissa A.; Daniels, Alan H.; Hulstyn, Michael J.; Eberson, Craig P.

doi:10.1007/s00167-012-2179-z

Cited by 55 publications

(91 citation statements)

References 25 publications

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“…An otherwise small OCF, if symptomatic, would have been excised [7]. Despite representing a last resort procedure, excision combined with microfractures grants satisfactory results, according to some studies [10]. We opted for internal fixation with two headless 1.7 mm titanium alloy screws.…”

Section: Discussionmentioning

confidence: 99%

Open Reduction and Internal Fixation of an Osteochondral Patellar Fracture in an Eleven Year-Old Girl

Correia¹

2016

MOJOR

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Osteochondral patellar fractures in pediatric age can result from acute patellar dislocations (APDs). The purpose of this article is to document and discuss the surgical treatment performed to a young female patient diagnosed with an osteochondral fracture (OCF) of the patella in the first episode of an APD.We state the first episode of an APD in a 12 year-old girl, who presented with pain, edema and limited extension of the right knee, after a direct knee trauma. She had no predisposing factors regarding patellofemoral instability. This patient was treated at our Orthopaedic Surgery Department and then clinically (Kujala score) and radiographically evaluated, at 12 months of follow-up.The knee radiograms gave rise to the suspicion of a large inferior osteochondral patellar fragment. Operative treatment was decided and open reduction and internal fixation (ORIF) of the fragment was performed, through a medial parapatellar approach. The fragment dimensions were 24x18mm. The medial structures were addressed and repaired. The patient went through a rehabilitation programme and returned to full activities three months postoperatively. After 12 months of follow-up, there was full range of motion, no redislocation episodes and the Kujala score was 96.Open reduction and anatomic in situ internal fixation of the osteochondral fragment was mandatory in this case, due to its dimensions and location. We consider this a safe and efficient technique that allows osteosynthesis of the osteochondral fragment; the approach used makes possible the acute repair of the medial structures. There is still no general consensus about whether or not to reconstruct the medial patellofemoral ligament (MPFL) in the context of a primary APD.

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Section: Discussionmentioning

confidence: 99%

Open Reduction and Internal Fixation of an Osteochondral Patellar Fracture in an Eleven Year-Old Girl

Correia¹

2016

MOJOR

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“…Diese Verletzungen sind durchaus ernst zu nehmen und kurzfristig mit einem deutlichen Funktionsverlust verbunden [19]. Langfristig sind zumindest fokale retropatellare Arthrosen zu beobachten, die nicht selten mit einer entsprechenden klinischen Symptomatik einhergehen (▶ Abb.…”

Section: Merkeunclassified

Knorpelverletzungen am Kniegelenk

Schmal¹

2017

Orthopädie und Unfallchirurgie up2date

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“…Osteochondral fracture (OCF) of the patella or lateral femoral condyle is rarely described in adults but occurs more frequently in adolescents during the first or, more rarely, recurrent patellar dislocation [1][2][3][4]. Due to the risk of complications manifested by early degenerative lesions in the patellofemoral joint, early diagnosis and operative treatment are required.…”

Section: Introductionmentioning

confidence: 99%

“…OCFs can be highly suspected in knees with intra-articular hematoma following patellar dislocation. Due to the difficulty in diagnosis, including even the failure to diagnose OCF, many studies highlight the need for multimodal diagnostics, including radiography (X-ray), computer-assisted tomography (CAT), or magnetic resonance imaging (MRI) [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Although fast and accurate diagnosis increases the possibility of restoring the articular surface by fixing the fractured fragment, no studies have so far reported the long-time clinical results including a MRI scan of the knee. Available articles are primarily based on case reports and low-number case series [2,[5][6][7][8][9][10][11]. Only a few articles are based on large case series with clinical and MRI follow-up [3,12].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation

Małecki

Pruchnik–Witosławska

Gwizdała

et al. 2019

BioMed Research International

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Aim. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. Methods. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. The mean age at the time of surgery was 14.1 years, and the mean follow-up period was 7.5 years. Results. The results of the patellar compression test and the apprehension test were negative in all patients. The mean Lysholm and Kujala scores were 89.2 and 89.6, respectively. The MRI scan revealed healing of the fixed fragment and restoration of the articular surface in all patients. In 16 cases, subchondral bone of the fixed fragment area was described as irregular: its articular cartilage was narrowed and not homogenous. Progressive degenerative changes were observed in the patellofemoral joint at follow-up in three patients. Conclusions. By fixing osteochondral fragments, the patellar articular surface can be restored. The MRI scans show that the cartilage in the reconstructed surface is narrowed after a mean 7.5-year follow-up.

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Adolescent patellar osteochondral fracture following patellar dislocation

Abstract: Retrospective case series, Level IV.

Cited by 55 publications

References 25 publications

Open Reduction and Internal Fixation of an Osteochondral Patellar Fracture in an Eleven Year-Old Girl

Open Reduction and Internal Fixation of an Osteochondral Patellar Fracture in an Eleven Year-Old Girl

Knorpelverletzungen am Kniegelenk

Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation

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