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Delniotis I, Leidinger B. Fixation of a chondral lateral femoral condyle fracture in a 13-year-old boy following patella dislocation using a new suture technique. J Surg Case Rep 2024; 2024:rjae367. [PMID: 38817797 PMCID: PMC11138669 DOI: 10.1093/jscr/rjae367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024] Open
Abstract
Osteochondral or, even more rarely, purely chondral fractures of the lateral femoral condyle following patella dislocation in adolescents are relatively infrequent. Various fixation methods are described in the literature, ranging from traditional screws to bioabsorbable constructs or the use of anchors. Each method possesses its own advantages and limitations. Here, we present a case involving a 13-year-old boy with a large purely chondral fracture of the lateral femoral condyle after patella dislocation, initially overlooked. We introduce a cost-effective suture-bridge technique for the fixation of this fracture, which eliminates the need for a second operation and has yielded favorable outcomes. It is important to know that fractures of this type can be easily overlooked, necessitating a high index of suspicion and the utilization of advanced imaging techniques to prevent potential long-term catastrophic outcomes for the knee joint.
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Affiliation(s)
- Ioannis Delniotis
- Specialised Paediatric Orthopaedics, Private Medical Practice, 54642, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Benedikt Leidinger
- Department of Pediatric- and Neuro-Orthopedics, Foot and Ankle Surgery, Orthopedic Clinic Volmarstein Wetter, Ruhr 58300, Germany
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Nudelman H, Lőrincz A, Lamberti AG, Varga M, Kassai T, Józsa G. Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants. J Clin Med 2024; 13:375. [PMID: 38256509 PMCID: PMC10816157 DOI: 10.3390/jcm13020375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/29/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
The incidence of articular injury, particularly osteochondral fractures (OCFs), has seen a cinnotable increase in recent years. Regardless of their location, fragments can be overlooked by plain radiographs, which might lead to osteoarthritis in the long run. Diagnostic imaging has a pivotal role in the assessment and classification of the fracture severity, as well as the presence of any associated dislocations. These fractures require surgical intervention for the restoration of joint function and the reduction of long-term complications. This paper aims to present the surgical correction and post-operative treatment of osteochondral fractures with absorbable implants in four children. The following affected areas are discussed: lateral condyle of the femur, patella and radial head. Utilising absorbable implants for the management of OCFs provides numerous advantages, including the elimination of the need for re-anaesthesia and reoperation, reduction of complications and facilitation of early rehabilitation. This approach also minimises the period of hospitalisation and proves effective in pediatric OCF treatment.
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Affiliation(s)
- Hermann Nudelman
- Division of Surgery, Traumatology and Otorhinolaryngology, Department of Paediatrics, Clinical Complex, University of Pécs, 7 József Attila Street, 7623 Pécs, Hungary
| | - Aba Lőrincz
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, 12 Szigeti Street, 7624 Pécs, Hungary
| | - Anna Gabriella Lamberti
- Division of Surgery, Traumatology and Otorhinolaryngology, Department of Paediatrics, Clinical Complex, University of Pécs, 7 József Attila Street, 7623 Pécs, Hungary
| | - Marcell Varga
- Department of Pediatric Traumatology, Péterfy Hospital, Manninger Jenő National Trauma Center, 17 Fiumei Street, 1081 Budapest, Hungary
| | - Tamás Kassai
- Department of Pediatric Traumatology, Péterfy Hospital, Manninger Jenő National Trauma Center, 17 Fiumei Street, 1081 Budapest, Hungary
| | - Gergő Józsa
- Division of Surgery, Traumatology and Otorhinolaryngology, Department of Paediatrics, Clinical Complex, University of Pécs, 7 József Attila Street, 7623 Pécs, Hungary
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, 12 Szigeti Street, 7624 Pécs, Hungary
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Huang W, Yang W, Meng C, Shao Z, Wang H. Arthroscopic In Situ Fixation of Osteochondral Fragments on the Weightbearing Area of the Knee Joint With a Single Anchor. Arthrosc Tech 2023; 12:e2133-e2139. [PMID: 38196873 PMCID: PMC10772958 DOI: 10.1016/j.eats.2023.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/20/2023] [Indexed: 01/11/2024] Open
Abstract
Osteochondral fracture of knee joint occurring in the femur is a serious clinical trauma. The presence of osteochondral fragments in the knee joint often necessitates surgery. Arthroscopic repair is a minimally invasive treatment, and there are many methods, among which suture anchor is often adopted by clinicians because of its obvious advantages such as simplicity. In the past, there were many methods for fixing osteochondral fragments, but using suture anchors to fix free osteochondral fragments has become a common approach. Moreover, the local mechanical environment will also be affected because of the increase in the number of bone channels. In this report, we describe a method for fixing 1 or 2 osteochondral fragments using a single suture anchor based on the mechanical characteristics of the femoral weightbearing region of the knee joint. We use relevant case reports to introduce our technology. Through the application of our improved technique, the arthroscopic repair of osteochondral fractures in the weightbearing area of femur can be more convenient and more economical, and the rehabilitation of patients will not be affected.
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Affiliation(s)
- Wei Huang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunqing Meng
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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