Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

Abstract

The incidence rate of articular injury is on the rise. With the help of imaging techniques, we classify the severity of the fracture and possible dislocations. Therapeutic interventions include the use of absorbable implants. The paper aims to present the surgical correction and post-operative treatment of osteochondral fractures with absorbable implants in three children. Affected areas are discussed as follows: lateral condyle of the femur, patella, and radial head. 1) A nine-year-old girl heard a sharp sound accompanied by pain after taking a careless step. Slight swelling of the knee was observed with the patella in place. Diagnostics revealed a broken piece of the femur’s lateral condyle located at the lateral recess. Under general anaesthesia, an arthrotomy was performed. The fragment was cleaned and reattached with absorbable nails. Postoperatively, a brace was applied for six weeks. 2) A 15-year-old boy was admitted due to a fall during ice skating, leading to rotational torsion of the knee. X-ray and CT imaging identified the osteochondral fracture of the patella. Based on these findings, an arthroscopy with arthrotomy was performed. 3) A 17-year-old girl fell while snowboarding, resulting in swelling of the proximal forearm. Imaging diagnostics confirmed the radial head fracture. Closed-fracture repositioning with absorbable implants was performed. The use of biodegradable implants eliminates the need for re-anaesthesia and reoperation, reducing the risks of complications. It also allows for earlier initiation of rehabilitation including physiotherapy. The efficiency of the method is further increased by a minimised hospital stay.