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Pediatric osteochondral fractures: clinical insights associate early diagnosis to early rehabilitation via arthroscopy.

Evmorfia Pechlivanidou, Christos Zambakides, Rodanthi E Margariti

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie(2024)

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Abstract
PURPOSE:This retrospective observational cohort analysis aims to address diagnostic and therapeutic challenges in managing osteochondral fractures (OCFs) resulting from acute patella dislocation and ankle sprains in children. METHODS:The study includes 15 children treated for OCFs between January 2020 and July 2022. Data were obtained from medical records and analyzed using logistic regression. RESULTS:The diagnostic and treatment algorithm involves detailed history, clinical examination, and imaging, with MRI guiding therapeutic decisions. Arthroscopic or mini open fixation led to successful rehabilitation, with 93% achieving full mobility at 9 months. Age was identified as a slight risk factor for free fragments in MRI, and arthroscopic management correlated with faster recovery at 3 months. CONCLUSION:This study underscores the importance of immediate diagnosis and minimally invasive intervention for OCFs in children. Timely treatment, guided by a diagnostic algorithm, facilitates joint restoration and prevents degenerative consequences, ensuring a return to regular activities within a year postoperatively. LEVEL OF EVIDENCE:IV.
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