DOI: http://dx.doi.org/10.18203/2349-2902.isj20215157

Malunion fracture of supracondylar femur sinistra with post traumatic arthritis and stiffness at genu sinistra: a case report

Jimmy Kuncoro, Muhammad Bayu Zohari Hutagalung, Dwikora Novembri Utomo

Abstract


Post-traumatic osteoarthritis could emerge immediately after an injury or one year after a bone fracture, ligament injury, and meniscal tears. In this case report, we present a 30 years old male who previously suffered from joint injury and thus lost the ability to flexion. This patient has already under went internal bone implantation surgery involving the implantation but was removed due to pain, and there was protruding implant on the left knee. On physical examination, there was varus deformity with flexion ranged between 0-5°. On radiological examination, malunion and narrowing of the joint surface were, as shown, clinically inhibit the flexion of the knee. We diagnose the patient with malunion supracondylar femur sinistra and post traumatic osteoarthritis genu sinistra. Liberation procedure (soft tissues release) and osteotomy of the distal femur were performed on this patient. On post-op radiological examination, the implant successfully widens the joint surface and holds the fracture fragment after it was reduced. The joint was immediately mobilize using the machine. It was shown that in a relatively short period, the range of motion could reach 90°. Three months post-op, evaluation was done, and it was clearly shown that the range of motion had not decreased.


Keywords


Malunion fracture, Supracondylar femur, Post traumatic arthritis, Stiffness of genu

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References


Thomas AC, Hubbard-Turner T, Wikstrom EA, Palmieri-Smith RM. Epidemiology of posttraumatic osteoarthritis. J Athl Train. 2017;52(6):491-6.

Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.

Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Casp J Intern Med. 2011;2(2):205.

Stiebel M, Miller LE, Block JE. Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies. Open access J Sport Med. 2014;5:73.

Hasan M, Shuckett R. Clinical features and pathogenetic mechanisms of osteoarthritis of the hip and knee. BC Med J. 2010;52(8):393-8.

Rollo G, Pichierri P, Grubor P, Marsilio A, Bisaccia M, Grubor M et al. The challenge of nonunion and malunion in distal femur surgical revision. Med Glas. 2019;16:2.

Ristevski B, Nauth A, Williams DS, Hall JA, Whelan DB, Bhandari M et al. Systematic review of the treatment of periprosthetic distal femur fractures. J Orthop Trauma. 2014;28(5):307-12.

Ekegren CL, Edwards ER, De Steiger R, Gabbe BJ. Incidence, costs and predictors of non-union, delayed union and mal-union following long bone fracture. Int J Environ Res Public Health. 2018;15(12):2845.

Kettelkamp DB, Hillberry BM, Murrish DE, Heck DA. Degenerative arthritis of the knee secondary to fracture malunion. Clin Orthop Relat Res. 1988;(234):159-69.

Pujol N, Boisrenoult P, Beaufils P. Post-traumatic knee stiffness: surgical techniques. Orthop Traumatol Surg Res. 2015;101(1):S179-86.

Bedi A, Haidukewych GJ. Management of the posttraumatic arthritic knee. JAAOS-Journal Am Acad Orthop Surg. 2009;17(2):88-101.

Ali AM, Villafuerte J, Hashmi M, Saleh M. Judet’s quadricepsplasty, surgical technique, and results in limb reconstruction. Clin Orthop Relat Res. 2003;415:214-20.