Arthroscopic controlled reduction of femoral condyle fractures using a retrograde navigated approach

Abstract

Isolated depression fractures of the femoral condyle are rare, but severe injuries due the destroyed congruency of the articular surface in the weight-bearing region of the joint. In most cases, an arthrotomy with fragment reduction and internal fixation by screws buttress or plates is performed. Disadvantages of this procedure are the approach-related complications. Furthermore, an implant removal is necessary, if a secondary osteoarthrosis develops. We present a female patient with a hyperflexion trauma of her right knee, resulting in an isolated depression fracture of the medial femoral condyle. To avoid arthrotomy-related morbidity, the impressed fragment was retrograde addressed using navigated guidance and reduced indirectly under arthroscopic control. Via the retrograde intraosseous tunnel a biodegradable screw was used as a buttress against the fragment to prevent a re-dislocation. The fracture healed without any complications and the patient re-administered her sports activities at 10 weeks follow-up. This procedure enables an accurate reduction and stable fixation of joint depression fragments via a minimal invasive approach.