Chondral and osteochondral fractures after luxation of the patella and their treatment

Abstract

The traumatic luxation of the patella is the most frequent cause of osteochondral or chondral fragments in the knee joint. A precise case history most often provides the necessary reference concerning the occurrence of a luxation. The hemarthrosis and the painful reduction of the mobility after a closed spontaneous reposition hint towards the possibility of a chondral or osteochondral fracture requiring an emergency arthrotomy. If large chondral or osteochondral fragments are found intraoperatively, then a refixation of these fragments should be attempted. The following methods can be used: --a fixation with ASIF-mini screws --a fixation with Smillie pins --a fixation with cortical nails or --the removal. We will report about these methods being used at our clinic and will discuss the results. Many differing surgical methods are available for a causative treatment of the patella luxation. The application of the necessary method is dependent upon the age of the patient as well as on the pathological-anatomical circumstances. The differing methods will be described. The successful results of a refixation using a fibrin glue cannot be judged finally.