Transchondral patellar fracture: a case report

Abstract

Osteochondral patellar fractures are usually associated with acute patellar dislocations and are often overlooked because of difficulty to detect on plain radiograms. These fractures should be anatomically reduced and fixed in order to prevent patellofemoral arthritis. A 20-year-old male patient complained of pain and swelling of the left knee after a rotational trauma during a football game, that resulted in patellar dislocation. A direct radiogram of the knee showed an osteochondral free fragment. Computed tomography of the knee showed hemarthrosis, a vertical patellar osteochondral defect involving the medial facet, and a free osteochondral fragment adjacent to the lateral wall of the lateral femoral condyle. At surgery, the fragment measured 33x25x7 mm and had a very thin bony portion. The fragment was reduced anatomically and fixed using three K-wires placed parallel to the articular surface. At the latest follow-up 1.5 years after the operation, the patient had full range of motion and normal knee radiograms. He returned to his pretrauma activity level.