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ORIGINAL ARTICLE
Year : 2019  |  Volume : 54  |  Issue : 1  |  Page : 90-96

Early results of surgically treated patellar osteochondral fracture following patellar dislocation in adolescents: a case series of ten patients


Orthopaedic Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt

Correspondence Address:
MD Osama Gamal
Orthopaedic Department, Faculty of Medicine, Menoufia University, Gamal Abdel Nasser Street, Shebin El Kom, Menoufia Governorate, 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eoj.eoj_29_19

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Background Adolescents having knee ligaments laxity are more predisposed to patellar dislocation. Associated patellar osteochondral fractures (OCFs) denote a main complication. Many surgical options have been described to treat such injury. This study aimed to assess the early results of operated patellar OCFs following traumatic patellar dislocation in adolescents. Patients and methods Ten adolescent patients diagnosed to have patellar OCFs following traumatic patellar dislocation were surgically treated. After employing an initial arthroscopic examination, if the fragment was big enough, it was fixed by headless titanium compression screws, or else, the loose body was removed and the base was managed with microfracture. Preoperatively and postoperatively, patients evaluation was carried out using the visual analogue scale for pain and postoperatively via the International Knee Documentation Committee score. Results The mean follow-up was 24 months. Five of 10 patients underwent fixation, whereas the other five underwent loose fragments removal with microfracture. The median of visual analogue scale for pain scores demonstrated highly significant improvement (from 8.8 preoperative to 1.55 postoperative, P=0.002). The median International Knee Documentation Committee scores of the nonfixation and fixation group were 85.1 and 74.7, respectively (P=0.144). Conclusion According to this study, the surgical treatment for patellar OCFs following traumatic patellar dislocation in adolescents using headless titanium compression screws or excision and microfracture gave significant improvement. Studies with more patients’ numbers and longer follow ups are still necessary to properly assess the benefits of such management protocol. Level of Evidence: IV.


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