An Unexpected Complication after Headless Compression Screw Fixation of an Osteochondral Fracture of Patella.

Suavi Aydoğmuş,Tolga Keçeci,Tahir Mutlu Duymuş

doi:10.1155/2016/7290104

Suavi Aydoğmuş, Tolga Keçeci + Show 1 more

Open Access

https://doi.org/10.1155/2016/7290104

Copy DOI

Abstract

This study evaluated complications associated with implant depth in headless compression screw treatment of an osteochondral fracture associated with a traumatic patellar dislocation in a 21-year-old woman. Computed tomography and X-rays showed one lateral fracture fragment measuring 25 × 16 mm. Osteosynthesis was performed with two headless compression screws. Five months later, the screws were removed because of patella-femoral implant friction. We recommend that the screw heads be embedded to a depth of at least 3 mm below the cartilage surface. Further clinical studies need to examine the variation in cartilage thickness in the fracture fragment.

Highlights

Osteochondral fractures of the patella may follow traumatic dislocations and can often be missed on the first radiographs taken after trauma [1]
This case report discusses the use of headless compression screws in the surgical treatment of patellar osteochondral fractures together with points requiring attention in the surgical technique
It was thought that friction caused by the headless compression screws in the patellofemoral joint had led to cartilage destruction, so we decided to remove the screws

Summary

Introduction

Osteochondral fractures of the patella may follow traumatic dislocations and can often be missed on the first radiographs taken after trauma [1]. Osteochondral injuries are caused by the shear stress that develops with lateral dislocation of the patella striking the medial femoral condyle and subsequent relocation [2]. There is a noticeable lack of information on the depth that headless compression screws should be embedded below the cartilage surface and the associated postoperative complications. This case report discusses the use of headless compression screws in the surgical treatment of patellar osteochondral fractures together with points requiring attention in the surgical technique

Case Presentation

Findings

Discussion