Tambe Deepak Anil, Kumar Pushpak, Gnany Jabez, Venugopal Vinayak, Kandarkar Sanket, Sayed Saif Rammathulla
Department of Orthopaedics, Rural Medical College, Pravara Medical Trust, Loni, Maharashtra, India.
J Orthop Case Rep. 2021 Jul;11(7):78-81. doi: 10.13107/jocr.2021.v11.i07.2326.
Anterior cruciate ligament (ACL) reconstruction using hamstring tendon graft is a commonly performed orthopedic surgery. Lateral femoral condyle fracture through the femoral tunnel is a rare complication following ACL reconstruction. These cases are reported to be managed in two stages, fracture fixation by open reduction and internal fixation with bone grafting of the femoral tunnel, followed by revision ACL reconstruction after the fracture union.
A 41-year-old male Kabaddi player underwent right knee arthroscopic ACL reconstruction following an ACL tear in January 2021, sustained a road traffic accident 7 weeks later and developed a lateral femoral condyle fracture. The graft was intact and trapped into the fracture site making fracture reduction difficult. The graft was lax due to the fixed loop button being trapped in the fracture. The patient was treated in a single stage by arthroscopy assisted fracture reduction and fixation with ACL graft salvage and reinforced suspensory femoral graft fixation to plate suspensory fixation.
This case is a rare presentation of lateral condyle fracture after ACL reconstruction and both the issues are managed in a single stage with the help of detailed surgical planning, using utmost arthroscopy skills and keeping all the options of fixation devices ready on the table during the surgery.
使用腘绳肌腱移植物进行前交叉韧带（ACL）重建是一种常见的骨科手术。股骨隧道导致的外侧髁骨折是ACL重建术后罕见的并发症。据报道，这些病例分两阶段处理，即通过切开复位和股骨隧道植骨内固定来固定骨折，然后在骨折愈合后进行ACL翻修重建。
一名41岁的卡巴迪运动员在2021年1月ACL撕裂后接受了右膝关节镜下ACL重建，7周后遭遇道路交通事故并发生外侧髁骨折。移植物完整但陷入骨折部位，导致骨折复位困难。由于固定环纽扣被困在骨折处，移植物松弛。该患者通过关节镜辅助骨折复位和固定进行单阶段治疗，同时挽救ACL移植物并加强悬吊股骨移植物至钢板悬吊固定。
该病例是ACL重建术后外侧髁骨折的罕见表现，借助详细的手术规划、精湛的关节镜技术以及在手术过程中准备好所有固定装置选项，两个问题在单阶段得到解决。
