TRAUMATIC CHONDRAL FRACTURE

Introduction

Chondral fractures are traumatic acute cartilage injuries, which may easily be missed, unless cautiously evaluated. Most common site for cartilage fractures is medial condyle of femur. MRI is highly spesific and sensitive for diasnosis of cartilage fractrues. It is frequently seen in normal cartilage with trauma, resulting acute extensive mechanic load to cartilage. However, corticosteroid therapy may have predisposed the articular cartilage to rupture with relatively mild mechanical stressors.

Case Report

26 year of male was presented with complaints of pain, after a knee trauma during a soccer game. MRI revealed, complet anterior cruciate ligament (ACL) rupture, bone bruise, hemarthrosis and MCL sprain. Mensici were normal. Besides these findings, a cartilage fragment was found, located anterior to ACL (Figure-1). MRI also revealed a large cartilage defect with clear-cut edges on lateral plateu of tibia (Figure-2 and 3). These findings are evaluated as cartilage fracture, preoperatively. Trauma patients should be evaluated carefully for cartilage fractures, since it may change the treatment of the patient. Replacement and fixation of the chondral fracture fragment is usually indicated when the chondral fragment is large.

References

1) Imaging of acute injuries of the articular surfaces (chondral, osteochondral and subchondral fractures). Klaus Bohndorf. Skeletal Radiol (1999); 28: 5454-560.
2) Chondral fracture of the lateral trochlea of the femur occurring in an adolescent: mechanism of injury. Yoshikazu Oohashi, Yoshinori Oohashi. Arch Orthop Trauma Surg (2007); 127:791–794.
3) MRI demonstration of occult purely chondral fractures of the tibia: a potential mimic of meniscal tears. Choll W.Kim, Diego Jaramillo, M.Timothy Hresko. Pediatr Radiol (1997); 27: 765–766.

Figure-1
Figure-2
Figure-3