Abstract

TEIXEIRA, Joana HF; BRITO, Joaquim; LOPES, Graça  and  AGUIAR, Thiago. Lesão osteocondral do Cõndilo femoral externo após luxação patelofemoral em idade pediátrica: A propósito de um caso clínico. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.3, pp.204-212. ISSN 1646-2122.

Osteocondral fractures sustained during acute patella dislocations are becoming an increasingly more common diagnosis with the growing importance of arthroscopy and MRI. These injuries frequently involve the medial patellar margin and the non-weight-bearing portion of the lateral trochlear margin. However osteochondral fractures involving the weight-bearing portion of the lateral femoral condyle are rare. Early diagnosis is key in preserving the remaining healthy cartilage, however delayed diagnosis is not uncommon, due to unspecific clinical presentation of knee sprain and the imaging techniques available in the emergency department. When suspecting an osteocondral fracture it is mandatory to perform an MRI for diagnostic confirmation and preoperative planning. The available treatment of choice of these rare fractures include osteosynthesis or excision with surgical debridement, either arthroscopically or through a small arthrotomy. Given their advantages and recent publication of promising results, arthroscopic fixation and bioabsorbable materials are becoming increasingly popular in the treatment of osteocondral fractures. Paediatric orthopaedic surgeons involved in the treatment of patellar instabilities should be aware of this unusual complication to assure its timely diagnosis and adequate treatment. The authors report a case of an osteochondral fracture involving the weight-bearing surface of the lateral condyle managed with mini-open reduction and bioabsorbable pin fixation under arthroscopic control, and resulting in successful clinical and radiographic results. Osteocondral healing was confirmed and the patient returned to sports without limitations.

Keywords : Osteochondral fracture; femoral condyle; patelofemoral instability; arthroscopy.

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