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      Application of mesh plate for the treatment of an osteochondral fracture of the medial femoral condyle with medial wall fracture: A case report

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          Abstract

          Osteochondral fractures of the medial femoral condyle accompanied by medial wall fracture are rare. Surgeons often have difficulty in selecting the most appropriate treatment, especially the plating technique for internal fixation since the available femoral locking plates are made to fit the femoral lateral condyle and there is no anatomical plate for the medial condyle. We, herein, report a case of a 44-year-old female patient who suffered from an osteochondral fracture of the medial femoral condyle accompanied by medial wall fracture treated by a low-profile mesh plate contoured to fit around the fracture site. Bone union was achieved at postoperative week 12 and the patient was able to return to her normal activities. At the 16-month follow-up exam, the patient’s functional and clinical outcomes were satisfactory. Her Oxford knee score was 47 points, and the Western Ontario and McMaster Universities Arthritis Index scores were 2 points for pain and 5 points for physical function. We believe that the mesh plate has several advantages. This is the first report of using a mesh plate for the femur, and we were able to achieve good results. We conclude that treatment with a mesh plate can be applied in well-selected patients with medial femoral condyle osteochondral fracture and has the potential to be applied to the treatment of fractures in various regions in the future.

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          Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

          Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.
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            First-time traumatic patellar dislocation: a systematic review.

            Acute patellar dislocations can result in patellar instability, pain, recurrent dislocations, decreased level of sporting activity, and patellofemoral arthritis. The initial management of a first-time traumatic patellar dislocation is controversial with no evidence-based consensus to guide decision making. Most first-time traumatic patellar dislocations have been traditionally treated nonoperatively; however, there has been a recent trend in initial surgical management. We performed a systematic review of Level I-IV studies to make evidence-based medicine recommendations on how a clinician should approach the diagnosis and treatment of a first-time traumatic dislocation. More specifically we answer the primary question of when initial treatment should consist of operative versus closed management. Based on the review of 70 articles looking at study design, mean followup, subjective and validated outcome measures, redislocation rates, and long-term symptoms, we recommend initial nonoperative management of a first-time traumatic dislocation except in several specific circumstances. These include the presence of an osteochondral fracture, substantial disruption of the medial patellar stabilizers, a laterally subluxated patella with normal alignment of the contralateral knee, or a second dislocation, or in patients not improving with appropriate rehabilitation.
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              Results at 10 to 14 years after osteochondral autografting (mosaicplasty) in articular cartilage defects in the knee.

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                Author and article information

                Journal
                Acta Orthop Traumatol Turc
                Acta Orthop Traumatol Turc
                Acta Orthopaedica et Traumatologica Turcica
                Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology
                1017-995X
                2589-1294
                May 2022
                01 May 2022
                : 56
                : 3
                : 228-231
                Affiliations
                [1 ]Department of Orthopedic Surgery , Kaneda Hospital, Okayama, Japan
                [2 ]Department of Orthopedic Surgery , Miyamoto Orthopedic Hospital, Okayama, Japan
                [3 ]Department of Orthopaedic Surgery and Traumatology , Kawasaki Medical School General Medical Center, Okayama, Japan
                [4 ]Department of Orthopaedic Surgery , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
                Author notes
                Corresponding Author: Norio Yamamoto norio-yamamoto@ 123456umin.ac.jp

                Cite this article as: Mochizuki Y, Yamamoto N, Noda T, Ozaki T. Application of mesh plate for the treatment of an osteochondral fracture of the medial femoral condyle with medial wall fracture: A case report. Acta Orthop Traumatol Turc 2022; 56(3): 228-231.

                ORCID IDs of the authors: Y.M. 0000-0002-7902-9994; N.Y. 0000-0002-7902-9994; T.N. 0000-0002-7066-1774; T.O. 0000-0003-1732-9307.

                Author information
                http://orcid.org/0000-0002-7902-9994
                http://orcid.org/0000-0002-7902-9994
                http://orcid.org/0000-0002-7066-1774
                http://orcid.org/0000-0003-1732-9307
                Article
                aott-56-3-228
                10.5152/j.aott.2022.21325
                9612640
                35703513
                f7ec6ad4-5a07-4efd-8048-b9632fff91f2
                2022 authors

                Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 02 March 2022
                : 24 March 2022
                Categories
                Case Report

                cartilage fracture,comminuted fracture,knee injuries

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