Osteochondral fracture in weight-bearing portion of lateral femoral condyle associated with patellar dislocation

Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

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Lateral femoral condyle osteochondral fracture combined to patellar dislocation: A case report

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2008.07.001 ◽

2009 ◽

Vol 95 (1) ◽

pp. 85-88 ◽

Cited By ~ 16

Author(s):

A. Callewier ◽

A. Monsaert ◽

G. Lamraski

Keyword(s):

Case Report ◽

Patellar Dislocation ◽

Femoral Condyle ◽

Lateral Femoral Condyle ◽

Osteochondral Fracture

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Two Patients with Osteochondral Injury of the Weight-Bearing Portion of the Lateral Femoral Condyle Associated with Lateral Dislocation of the Patella

Case Reports in Orthopedics ◽

10.1155/2014/876410 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Shuji Nakagawa ◽

Yuji Arai ◽

Hiroaki Inoue ◽

Satoru Atsumi ◽

Shohei Ichimaru ◽

...

Keyword(s):

Patellar Dislocation ◽

Femoral Condyle ◽

Weight Bearing ◽

Lateral Femoral Condyle ◽

Bearing Surface ◽

Lateral Dislocation ◽

Osteochondral Injury ◽

Osteochondral Fragment ◽

Femoral Groove ◽

Dislocation Of The Patella

Complications of patellar dislocation include osteochondral injury of the lateral femoral condyle and patella. Most cases of osteochondral injury occur in the anterior region, which is the non-weight-bearing portion of the lateral femoral condyle. We describe two patients with osteochondral injury of the weight-bearing surface of the lateral femoral condyle associated with lateral dislocation of the patella. The patients were 18- and 11-year-old females. Osteochondral injury occurred on the weight-bearing surface distal to the lateral femoral condyle. The presence of a free osteochondral fragment and osteochondral injury of the lateral femoral condyle was confirmed on MRI and reconstruction CT scan. Treatment consisted of osteochondral fragment fixation or microfracture, as well as patellar stabilization. Osteochondral injury was present in the weight-bearing portion of the lateral femoral condyle in both patients, suggesting that the injury was caused by friction between the patella and lateral femoral condyle when the patella was dislocated or reduced at about 90° flexion of the knee joint. These findings indicate that patellar dislocation may occur and osteochondral injury may extend to the weight-bearing portion of the femur even in deep flexion, when the patella is stabilized on the bones of the femoral groove.

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