Fixation of the neglected subcutaneous osteochondral fragment of large medial femoral condyle defect in adult male: A case report


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AKKAYA M., ŞİMŞEK M. E., Caglar C., Nazligul A. S., Akcaalan S., GÜRSOY S.

Journal of ISAKOS, vol.7, no.3, pp.39-43, 2022 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 7 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.1016/j.jisako.2022.02.001
  • Journal Name: Journal of ISAKOS
  • Journal Indexes: Scopus
  • Page Numbers: pp.39-43
  • Keywords: Internal fixation, Knee, Medial femoral condyle, Osteochondral fragment
  • Lokman Hekim University Affiliated: Yes

Abstract

© 2022 The Author(s)Knee osteochondral fractures are one of the most common orthopedic injuries and their diagnosis and treatment is always open to debate among orthopedic surgeons. In this case report, we described the surgical treatment and two years follow-up of an adult male patient, who underwent delayed osteochondral fixation with an iliac graft. A medial parapatellar incision was made to perform open reduction and internal fixation. The fracture surface at the medial condyle of the femur was debrided with a curette, followed by placement of the tricortical graft harvested from the iliac crest into the defect at the medial femoral condyle. The osteochondral fragment was then placed on top and fixed with three headless compression screws together with the iliac crest graft for joint surface restoration. While the patient's preoperative knee injury and osteoarthritis outcome score (KOOS) was 38 and it increased to 74 during two years follow-up. Despite the scarcity of information on delayed fixation of osteochondral fractures, osteochondral fragments with preserved viability should be fixed, regardless of the timing, as suggested by the successful outcomes obtained in this study.