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Observational Study
. 2024 Apr;34(3):1657-1665.
doi: 10.1007/s00590-024-03852-7. Epub 2024 Feb 20.

Pediatric osteochondral fractures: clinical insights associate early diagnosis to early rehabilitation via arthroscopy

Evmorfia Pechlivanidou  1   2 , Christos Zambakides  3 , Rodanthi E Margariti  3
Affiliations
Observational Study

Pediatric osteochondral fractures: clinical insights associate early diagnosis to early rehabilitation via arthroscopy

Evmorfia Pechlivanidou et al. Eur J Orthop Surg Traumatol. 2024 Apr.

Abstract

Purpose: This retrospective observational cohort analysis aims to address diagnostic and therapeutic challenges in managing osteochondral fractures (OCFs) resulting from acute patella dislocation and ankle sprains in children.

Methods: The study includes 15 children treated for OCFs between January 2020 and July 2022. Data were obtained from medical records and analyzed using logistic regression.

Results: The diagnostic and treatment algorithm involves detailed history, clinical examination, and imaging, with MRI guiding therapeutic decisions. Arthroscopic or mini open fixation led to successful rehabilitation, with 93% achieving full mobility at 9 months. Age was identified as a slight risk factor for free fragments in MRI, and arthroscopic management correlated with faster recovery at 3 months.

Conclusion: This study underscores the importance of immediate diagnosis and minimally invasive intervention for OCFs in children. Timely treatment, guided by a diagnostic algorithm, facilitates joint restoration and prevents degenerative consequences, ensuring a return to regular activities within a year postoperatively.

Level of evidence: IV.

Keywords: Acute patella dislocation; Ankle sprain; Arthroscopy; Bioabsorbable pins; Osteochondral fracture.

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Conflict of interest statement

All authors don’t have any competing interest to declare.

Figures

Fig. 1
Fig. 1
Flow diagram for the sample collection
Fig. 2
Fig. 2
Imaging pre- and postoperatively for the 3 types of management: a free fragment in the knee treated by mini open fixation (preoperative plain radiograph and MRI); b knee osteochondral lesion treated by arthroscopic fixation (preoperative plain radiograph, preoperative MRI, and postoperative MRI); c talus-free fragment treated by mini open fixation (pre- and postoperative plain radiograph)
Fig. 3
Fig. 3
Diagnostic and treatment algorithm used in this case series
See this image and copyright information in PMC

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