Arthroscopic Bone Graft and Screw Fixation
Case 1: Type 3 Large Unstable MFC OCD
MRI
MRI demonstrates large OCD with fluid completely separating bone on all views
Plan
Probably unstable
MRI demonstrates large OCD with fluid completely separating bone on all views
Probably unstable
European Orthopaedic Paediatric Study JPO 1999
- 452 patients
- juvenile and adult
Findings
- stable lesion with cartilage intact and no dissection had good prognosis
- if signs dissection, surgical management better than non surgical
- sclerosis on x-ray poor prognostic sign
- lesions > 2cm poor prognosis
- 20% OCD in juveniles abnormal x-ray findings at 3 years (not benign process)
Osteochondritis Dissecans
- separation of avascular fragment of bone & cartilage
M : F = 2:1
Mean age 18 years
- can present as young as 9
4:1000
Fracture talus through articular cartilage into subchondral bone
- 2° force transmitted from distal tibia
Osteochondritis dissecans v osteochondral fracture
6% ankle sprains
Average age = 25
M > F