Internal fixation of juvenile XXXX of the knee.

@entity1843 @entity1 @entity5631 @entity5
BACKGROUND: Operative techniques for the management of juvenile @entity1843 of the knee include drilling, internal fixation, fragment removal, and chondral resurfacing. PURPOSE: To evaluate the functional and radiographic outcome of internal fixation of juvenile @entity1843 of the knee. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The study design was a retrospective case series. Twenty-six knees in 24 skeletally immature @entity1 underwent internal fixation of @entity1843 . Mean follow-up was 4.25 years (range, 2-14.75 years). Mean @entity1 age was 14.7 years (range, 11-16 years). There were 13 @entity1 and 11 @entity1 . Lesions were graded per the Ewing and Voto classification, with 9 stage II lesions (fissured), 11 @entity5 (partially attached), and 6 stage IV lesions (detached). Methods of internal fixation included variable pitch screws (n = 11), bioabsorbable tacks (n = 10), partially threaded cannulated screws (n = 3), and bioabsorbable pins (n = 3). Mean follow-up was 4.25 years (range, 2.0-14.75 years). RESULTS: Healing occurred in 22 of 26 lesions (healing rate, 84.6%). There was no significant difference in healing rate for lesion location, fixation method, or lesion grade. In fact, all 6 stage IV (detached) lesions healed. The mean postoperative Lysholm score was 85.8, mean postoperative International Knee Documentation Committee score was 82.6, and mean postoperative Tegner activity level was 7.4. Mean time to healing was 6 months. Eight @entity1 underwent additional procedures: 4 for nonunion, 1 for @entity5631 , and 3 for elective screw removal. CONCLUSION: Given the relatively high healing rate, good functional outcome, and low complication rate, the authors advocate internal fixation of unstable juvenile @entity1843 of the knee, even for detached lesions and in @entity1 with a history of surgery for the @entity1843 .
