Bone peg fixation of a large chondral fragment in the weight-bearing portion of the lateral femoral condyle in an adolescent: a case report.
Bone peg fixation of a large chondral fragment in the weight-bearing portion of the lateral femoral condyle in an adolescent: a case report.
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DOI：
10.1186/1752-1947-8-316
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发表时间：
2014-09-23
影响因子：
1
通讯作者：
Yoshiya S
中科院分区：
文献类型：
--
作者：
Nakayama H;Yoshiya S
膝关节软骨骨折相对罕见，这种损伤的最佳治疗方案仍然存在争议。在这份报告中，我们介绍了一个病人的情况下，这种损伤谁是手术治疗使用骨钉固定程序。尚无文献报道使用该技术固定分离的软骨碎片。患者是一名14岁的日本男孩，在踢足球时膝盖受伤。尽管常规X线片显示无异常，但磁共振成像显示其股骨外侧髁承重部分存在大的全层软骨缺损，前部区域存在分离的软骨碎片。缺损（碎片）尺寸为2cm × 1.5cm。在手术中，软骨碎片用从胫骨前内侧采集的八个皮质骨钉固定。术后4个月的磁共振成像和12个月的关节镜二次检查显示骨折块明显愈合。在26个月的最后一次随访检查中，体格检查显示没有肿胀，恢复了全方位的运动，他可以在受伤前的水平踢足球，没有任何抱怨。根据该患者的临床病程，认为骨钉固定是膝关节大型软骨骨折固定的一种有价值的选择。
Chondral fracture of the knee is relatively rare and the optimal treatment option for this injury is still controversial. In this report, we present the case of a patient with this injury who was treated surgically using the bone peg fixation procedure. There has been no literature reporting the use of this technique for fixation of a detached chondral fragment. The patient was a 14-year-old Japanese boy who sustained a knee injury while kicking a soccer ball. Although routine radiographs showed no abnormality, magnetic resonance imaging showed a large full-thickness chondral defect in the weight-bearing portion of his lateral femoral condyle and a detached chondral fragment in the anterior region. The size of the defect (fragment) was 2cm by 1.5cm. At surgery, the chondral fragment was fixed with eight cortical bone pegs that were harvested from the anteromedial aspect of his tibia. The postoperative magnetic resonance imaging at 4 months and the second-look arthroscopy at 12 months revealed apparent healing of the fragment. In the final follow-up examination at 26 months, a physical examination showed no swelling with recovery of full range of motion, and he could play soccer at the pre-injury level with no complaint. Based on the clinical course of this patient, it is thought that bone peg fixation can be a valuable option for fixation of a large chondral fracture of the knee.