Arthroscopically assisted intra-articular lateral femoral condyle fracture surgery

Abstract

As with any other intra-articular fracture, the distal intra-articular femoral fracture has always been a challenge for orthopaedic surgeons because of the wide variety of trauma with which it is associated, and because associated soft-tissue injuries further augment its complexity. In articular fractures of the distal femur, arthroscopy allows rinsing of the articulation to visualize and also to assess intra-articular meniscal or ligamentous lesions, as well as the quality of the reduction. After a fall from a ladder, a 34-year-old man experienced a distal femoral intra-articular fracture (type B1) on the left side. Standard arthroscopic portals were used and the joint was irrigated and blood clots were evacuated. Through a lateral incision, 2 guidewires were placed perpendicular to the fracture. Cannulated 6.5-mm screws with washers were threaded over the guidewires and compression and anatomic reduction of the fracture site was obtained. The reduction quality was confirmed arthroscopically after irrigation. The fracture was shown to have healed radiographically and clinically by 3 months and the patient was back to work without limitations. Instead of using an arthrotomy for Müller type B1 lateral femoral condyle fractures, internal fixation assisted with arthroscopy will be a valuable technique with the advantage of identifying associated intra-articular pathology.