Histological evidence of successful internal fixation for traumatic chondral fracture of the femoral groove

Isolated chondral fractures without cancellous bone have limited healing potential. We reattached a chondral fragment without cancellous bone using bone pegs for chondral fracture of the femoral groove in a 13-year-old boy. Five months after the surgery, we performed a biopsy to evaluate the histological findings for the healed osteochondral junction. Biopsy results showed that osteoblasts had proliferated in the subchondral layer, and some osteoblasts had invaded the calcified cartilage, suggesting active new bone formation. A tidemark was observed between the radial cartilage layer and the calcified cartilage, and it was evident that the osteochondral junction had been completely restored. Four years and 3 months after the surgery, magnetic resonance imaging revealed that the cartilage on the femoral groove was maintained and the patient can play basketball asymptomatically. This report shows that surgeons can attempt the reattachment of chondral fragments without cancellous bone in adolescent patients.