Chondral fracture of the lateral femoral condyle in children with different treatment methods

Abstract

Adolescents are predisposed to chondral injuries of the knee; however, the incidence of traumatic chondral and osteochondral fractures and their role in the development of joint degeneration are not fully elucidated. Several methods are described for the treatment of chondral or osteochondral fractures of the knee. In our literature review, we could not find any report on the management of chondral fractures with autologous bone pegs or headless screws. We report three cases of traumatic cartilage fractures of the lateral femoral condyle in adolescents who were treated with three different methods. We also present their follow-up outcomes.

Large chondral fragment of the lateral femoral condyle treated with arthroscopic internal fixation in an elite young athlete

“…Maletius and Lundberg reported poor healing potential in two cases of chondral fragment fixation, subsequently questioning the efficacy of this technique [7]. Recent reports, however, have shown successful fixation of purely cartilaginous lesions [8][9][10][11][12][13][14][15]. All cases were performed with open arthrotomies, except one case of a 22-year-old patient who underwent fixation of a 1.5 cm 2 cartilage fragment with arthroscopy [15].…”

“…All cases were performed with open arthrotomies, except one case of a 22-year-old patient who underwent fixation of a 1.5 cm 2 cartilage fragment with arthroscopy [15]. Previously described methods of fixation of these cartilage fragments include bone pegs, chondral darts, bioabsorbable nails, and headless screws, of which can be augmented by fibrin glue or suture [8][9][10][11][12][13][14][15].…”

“…While displaced osteochondral lesions amenable to fixation have shown good outcomes [4][5][6], the success of fixation when cartilage fragments are devoid of subchondral bone is rarely described and previously been questioned [7]. The evidence for reduction and internal fixation of large cartilage fragments is limited to case reports [8][9][10][11][12][13][14][15], and the purpose of this study is to contribute yet another case to the literature of successful primary fixation of a large chondral fragment in the knee, here in a highly active young patient.…”

Distal radius fracture with associated ulnar head fracture

“…5 The use of a headless screw is particularly suited to a fairly large fracture fragment involving articular cartilage. 6,7 Though this is not a novel concept, it facilitates rigid intraarticular fixation. The screw was inserted horizontally at almost 908 to the fracture line.…”

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

“…Several treatments have been proposed for injuries with osteochondral fragments, such as fixation with metallic or absorbable materials, autologous osteochondral transplantation, and simple debridement. 1 , 7 , 8 However, in some rare cases, the injuries are solely cartilaginous or have minimal underlying subchondral bone, preventing the use of bone fixation. In addition to the technical difficulty of the fixation, the healing potential is lower in cartilage than in bone.…”