title: Bone peg fixation of a large chondral fragment in the weight-bearing portion of the lateral femoral condyle in an adolescent: a case report.
abstract: BACKGROUND
  Chondral fracture of the knee is relatively rare and the optimal treatment option for this injury is still controversial. In this report, we present the case of a patient with this injury who was treated surgically using the bone peg fixation procedure. There has been no literature reporting the use of this technique for fixation of a detached chondral fragment.
  
  
  METHODS
  The patient was a 14-year-old Japanese boy who sustained a knee injury while kicking a soccer ball. Although routine radiographs showed no abnormality, magnetic resonance imaging showed a large full-thickness chondral defect in the weight-bearing portion of his lateral femoral condyle and a detached chondral fragment in the anterior region. The size of the defect (fragment) was 2 cm by 1.5 cm. At surgery, the chondral fragment was fixed with eight cortical bone pegs that were harvested from the anteromedial aspect of his tibia.
  
  
  CONCLUSIONS
  The postoperative magnetic resonance imaging at 4 months and the second-look arthroscopy at 12 months revealed apparent healing of the fragment. In the final follow-up examination at 26 months, a physical examination showed no swelling with recovery of full range of motion, and he could play soccer at the pre-injury level with no complaint. Based on the clinical course of this patient, it is thought that bone peg fixation can be a valuable option for fixation of a large chondral fracture of the knee.
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. hiroshi0273@mac.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshiya
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D005269:Femur / Q000502:physiology / Q000601:surgery*; D050724:Fractures, Cartilage / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000502:physiology / Q000601:surgery*; D008297:Male; D013977:Tibia / Q000637:transplantation*; D016474:Weight-Bearing