Abstract
Aim
Case Report presentation of traumatic cartilage loss in a child.
Method
We present a case report of a 3-year-old girl who sustained a severe open fracture dislocation of her talus with complete loss of full thickness articular cartilage and subchondral bone over 80% of the talar dome. At presentation there was also a Salter Harris I fracture of the fibular, and an extensive soft tissue defect including absent anterior joint capsule. She required a free anterolateral thigh (ALT) flap to reconstruct this defect. The talar dome defect was treated with a cell-free chondro-inductive implant. This was the first use of this implant in the UK and the first use of such an implant in a child anywhere in the world.
Result
At 3 years post-operative, the patient underwent thinning of the ALT flap and trimming of an anterior tibial overgrowth, which was causing impingement. At surgery the talar dome cartilage was looked pristine, with a line representing the tidemark between the original cartilage and the new formed. Biopsies were taken and histopathology performed. This was a rare and difficult case that has achieved a satisfactory outcome at this follow up stage.
Conclusion
Cell-free chondro-inductive implants may hold promise for the treatment full thickness articular cartilage defects in children.
