title: Arthroscopic controlled reduction of femoral condyle fractures using a retrograde navigated approach.
abstract: Isolated depression fractures of the femoral condyle are rare, but severe injuries due the destroyed congruency of the articular surface in the weight-bearing region of the joint. In most cases, an arthrotomy with fragment reduction and internal fixation by screws buttress or plates is performed. Disadvantages of this procedure are the approach-related complications. Furthermore, an implant removal is necessary, if a secondary osteoarthrosis develops. We present a female patient with a hyperflexion trauma of her right knee, resulting in an isolated depression fracture of the medial femoral condyle. To avoid arthrotomy-related morbidity, the impressed fragment was retrograde addressed using navigated guidance and reduced indirectly under arthroscopic control. Via the retrograde intraosseous tunnel a biodegradable screw was used as a buttress against the fragment to prevent a re-dislocation. The fracture healed without any complications and the patient re-administered her sports activities at 10 weeks follow-up. This procedure enables an accurate reduction and stable fixation of joint depression fragments via a minimal invasive approach.
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07740, Jena, Germany. marc.gras@med.uni-jena.de
authors.forename: Florian
authors.initials: F
authors.lastname: Gras
authors.forename: Ivan
authors.initials: I
authors.lastname: Marintschev
authors.forename: Veit
authors.initials: V
authors.lastname: Koenig
authors.forename: Arne
authors.initials: A
authors.lastname: Wilharm
authors.forename: Thomas
authors.initials: T
authors.lastname: Mueckley
authors.forename: Gunther O
authors.initials: GO
authors.lastname: Hofmann
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D016896:Treatment Outcome