Lateral femoral condyle osteochondral fracture combined to patellar dislocation: A case report

Abstract

The authors report the case of an osteochondral fracture involving the weight-bearing portion of the lateral femoral condyle in a 23-year-old sportsman. The defect was concomitant to a lateral patellar dislocation involving a rare injury mechanism. Fixation of the osteochondral fragment was performed with bioabsorbable pins and healing was achieved within an acceptable time. Clinical and radiographic outcome at one year is highly satisfactory and bioabsorbable implant fixation reveals to be a worthwhile option in such a case. This rare lesion is diagnostically challenging and requires an adapted and prompt treatment.

Cartilage Lesions in Patellofemoral Dislocations

“…However, several case reports have been described in the literature suggesting that these injuries can be more extensive and affect the weight-bearing surface of the lateral femoral condyle 26,27 when the injury (often delamination) extends from the lateral margin of the condyle to the central region of the condyle (Figure 2A-D). Mashoof et al described this injury in a retrospective review of 7 cases over a six-year period of patellar dislocation from noncontact injury.…”

“…26 Calleweir et al later reported of a single case of a non-contact patellar dislocation in a 23 year-old patient that experienced resultant osteochondral fracture of the weight-bearing surface of the lateral femoral condyle. 27 Sanders et al (2006) published a review of acute patellar dislocation and associated MRI findings. In this retrospective radiological review of 25 cases, 20% (5/25) had an osteochondral injury to the mid-lateral weight-bearing portion of the lateral femoral condyle; 28 evidence that these injuries are perhaps more common than previously reported.…”

A rare case of bilateral non-weight bearing posterior aspect of lateral femoral condyle osteochondral fracture and its management

“…When diagnosed within 2 weeks of onset then they should best be treated by open reduction and internal fixation, (ORIF) with the use of adequate implant for fixation like bioabsorbable screws3 4 or rods, etc. On the other hand, excision seems to be the best outcome of choice for chronic fragments or fractures2 7 as there is propensity for non-union and loose body formation.…”

“…On the other hand, osteochondral fracture within the knee joint may be caused by impaction, avulsion or sheering forces 2. Lateral patellar dislocation can also lead to osteochondral injury to anteriolateral non-weight bearing (NWB) part of the LFC 3. There are large numbers of published reports on osteochondral fractures of the weight bearing articular surface of the LFC and their management,4 while the posterior NWB aspect of LFC is a relatively rare site of injury as it involves hyperflexion of the knee at the time of direct or indirect contact injury mechanism.…”

Arthroscopically-assisted reduction and fixation of an old osteochondral fracture of the lateral femoral condyle

“…OCF commonly has a definitive trauma history and is sometimes accompanied with patellar dislocation [3,5]; the dislocated patella impacts the lateral femoral condyle, causing the fracture. OCF also may occur independently [2], which is induced by acute shearing force on the lateral femoral condyle.…”