Large Osteochondral Fractures of the Lateral Femoral Condyle in the Adolescent: Outcome of Bioabsorbable Pin Fixation

Walsh, Stewart J.; Boyle, Matthew J.; Morganti, Vicki
July 2008
Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1473
Academic Journal
Background: Large osteochondral fractures of the lateral femoral condyle of the knee in adolescent patients can be diagnostically and therapeutically challenging. Historically, management has involved removal of the fragment, leaving a large area of bone devoid of articular cartilage on the weight-bearing surface of the lateral femoral condyle. This study assessed open reduction and internal fixation of the osteochondral fragments with use of multiple polyglycolic acid rods. Methods: Eight patients, between twelve and fifteen years old, with a large (>4 cm²) osteochondral fracture of the lateral femoral condyle were treated with open reduction and internal fixation with use of multiple polyglycolic acid rods. Each patient was evaluated at more than five years (a mean of nine years) after the index procedure with a clinical assessment, during which the knee was scored according to the International Knee Documentation Committee and Cincinnati knee rating systems, plain radiographs were made, and magnetic resonance imaging scans were acquired. Results: The majority of patients scored well on both knee rating systems, with no poor results. Five of the eight patients had normal findings on knee radiographs, and three had radiographs that showed minor changes. Magnetic resonance imaging scans of all cpatients demonstrated intact articular cartilage in the lateral compartment with no area of full-thickness articular cartilage loss. No evidence of articular cartilage thinning was seen in two knees; a small area of <2 cm² of cartilage thinning, in four; a moderate area of 2.7 cm² of cartilage thinning, in one; and a large area of 11.2 cm² of abnormal cartilage signal, in one knee. Conclusions: Osteochondral fracture of the lateral femoral condyle is an injury to which adolescents with ligamentous laxity of the knee are prone. Our results show that internal fixation of these osteochondral fragments with bioabsorbable implants is possible and is a worthwhile option.


Related Articles

  • Conservative versus surgical management of Pipkin type I fractures associated with posterior dislocation of the hip: a randomised controlled trial. Chen, Zhi-wen; Lin, Bin; Zhai, Wen-liang; Guo, Zhi-min; Liang, Zhou; Zheng, Jia-Peng; Lian, Ke-jian; Ding, Zheng-qi // International Orthopaedics;Jul2011, Vol. 35 Issue 7, p1077 

    The aim of this study was to evaluate the long-term results of conservative and surgical fragment excision treatment in patients with Pipkin type 1 fractures of the femoral head associated with posterior dislocation of the hip by a randomised controlled trial. Sixteen patients were randomly...

  • Common Knee Surgery Appears to Have Little Benefit.  // Health Letter;Feb2014, p1 

    The article discusses various reports that have revealed that the commonly used arthroscopic surgery to repair tears in meniscal cartilage of the knees is a fake surgical procedure and offers no significant benefit for most U.S. patients.

  • Arthroscopic treatment of lateral epicondylitis: comparison of the outcome of ECRB release with and without decortication. Jeong Woo Kim; Churl Hong Chun; Dae Moo Shim; Tae Kyun Kim; Seok Hyun Kweon; Hong Je Kang; Kyu Hwan Bae // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2011, Vol. 19 Issue 7, p1178 

    Purpose: The purpose of this study was to compare the early clinical results of arthroscopic extensor carpi radialis brevis (ECRB) release with and without bone decortication in the treatment of lateral epicondylitis. Materials and methods: Thirty-eight patients who were surgically treated for...

  • Association of psychological status and patient-reported physical outcome measures in joint arthroplasty: a lack of divergent validity. Giesinger, Johannes M.; Kuster, Markus S.; Behrend, Henrik; Giesinger, Karlmeinrad // Health & Quality of Life Outcomes;2013, Vol. 11 Issue 1, Special section p1 

    Background: Patient-reported outcome measures have become a well-recognised part of outcome assessment in orthopaedic surgery. These questionnaires claim to measure joint-specific dimensions like pain, function in activities of daily living, joint awareness or stiffness. Interference of the...

  • A 4-Week Neuromuscular Training Program and Gait Patterns at the Ankle Joint. Coughlan, Garrett; Caulfield, Brian // Journal of Athletic Training (National Athletic Trainers' Associ;Jan-Mar2007, Vol. 42 Issue 1, p51 

    Context: Previous research into the rehabilitation of ankle sprains has primarily focused on outcome measures that do not replicate functional activities, thus making it difficult to extrapolate the results relative to the weight-bearing conditions under which most ankle sprains occur....

  • Measures of outcome in patients with inflammatory arthritis. Palmer, Deborah; El Miedany, Yasser // British Journal of Nursing;9/11/2008, Vol. 17 Issue 16, p1052 

    Background: Musculoskeletal disorders account for 15-20% of general practitioner (GP) consultations and cause significant morbidity and disability. Although rheumatology nursing is regarded as a partnership between the practitioner and patient, it remains a relatively tough task to generate a...

  • Early Operation on Patients with a Hip Fracture Improved the Ability to Return to Independent Living. Al-ani, Amer N.; Samuelsson, Bodil; Tidermark, Jan; Norling, Åsa; Ekström, Wilhelmina; Cederhoim, Tommy; Hedström, Margareta // Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1436 

    Background: The outcome for many patients with a hip fracture remains poor. The aim of the present study was to investigate whether the timing of surgery in such patients could influence the short-term clinical outcome. Methods: We included 850 consecutive patients with a hip fracture who were...

  • Computer-Assisted Surgery for Subtalar Arthrodesis. Easley, Mark; Chuckpaiwong, Bavornrit; Cooperman, Nathan; Schuh, Reinhard; Ogut, Tahir; Le, Ian L. D.; Reach, John // Journal of Bone & Joint Surgery, American Volume;Aug2008, Vol. 90-A Issue 8, p1628 

    Background: Despite considerable recent interest in computer navigation for orthopaedic surgery, few investigations of computer-assisted surgery for foot and ankle operations have been reported. The purpose of the present study was to compare subtalar arthrodesis with and without computer...

  • Results and Lessons Learned from a United States Hip Resurfacing Investigational Device Exemption Trial. Stulberg, Bernard N.; Trier, Kathy K.; Naughton, Marybeth; Zadzilka, Jayson D. // Journal of Bone & Joint Surgery, American Volume;Aug2008 Supplement 3, Vol. 90-A, p21 

    Background: Improvements in metal-on-metal bearings have made hybrid hip surface replacement a potential alternative for the young active patient with end-stage hip disease. Possible advantages include greater hip joint stability, bone preservation, and decreased osteolysis. In this study, we...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics