Osteochondral Fragment Fixation in Transient Patellar Dislocation of an Adolescent: A Case Report
Correspondence Address :
Dr. Mohammed Talha Muneer,
702, 7th Floor, Shankeshwar Darshan, Nehru Nagar Chowk, Pimpri, Pune-411018, Maharashtra, India.
E-mail: talha.m1432@gmail.com
Osteochondral Fractures (OCFs) of the patella are common in adolescents due to ligament laxity and weak osteochondral junctions. OCFs following patellar dislocation are particularly challenging in this age group. Magnetic Resonance Imaging (MRI) aids in comprehensive evaluation, and surgical fixation with bioabsorbable sutures is a reliable treatment option. Early intervention and proper rehabilitation are essential to ensure optimal outcomes and prevent long-term complications. The present case report details the presentation, diagnosis, surgical intervention and outcome of a 16-year-old male with an OCF following patellar dislocation. Examination revealed significant ligament laxity and patellar hypermobility, along with patella alta (Insall-Salvati ratio of 2.1) on the affected side. The neurovascular examination was normal. Initial X-rays showed no abnormalities; however, Computed Tomography (CT) and MRI scans revealed a displaced OCF fragment in the anterior intercondylar region, along with lateral patellar tilt, marrow contusion, chondral delamination and partial thickness tearing of the Medial Patellofemoral Ligament (MPFL). Surgical intervention involved open reduction and internal fixation using absorbable Vicryl sutures. Postoperatively, the patient was immobilised for six weeks, followed by a structured rehabilitation program. The patient achieved a full range of motion and restored knee function within six months, with satisfactory radiographic and functional outcomes. At the latest follow-up, the knee range of motion was from 0 degrees of extension to 130 degrees of flexion, with complete pain alleviation. OCFs of the patella in adolescents require timely diagnosis and intervention to prevent degenerative changes. MRI is essential for evaluating soft tissue injuries. Surgical fixation using bioabsorbable sutures provides effective treatment, offering strong fixation without the need for implant removal. Addressing associated injuries, such as MPFL tears, is crucial to prevent recurrent dislocation.
Absorbable Implants, Articular, Knee dislocation, Ligaments
DOI: 10.7860/JCDR/2024/73125.20205
Date of Submission: May 27, 2024
Date of Peer Review: Jun 21, 2024
Date of Acceptance: Aug 02, 2024
Date of Publishing: Oct 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• Plagiarism X-checker: Jun 03, 2024
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ETYMOLOGY: Author Origin
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