Arthroscopy Assisted Reduction and Internal Fixation of a Lateral Femoral Condyle Fracture after Anterior Cruciate Ligament Reconstruction with Graft Salvage and Reinforced Suspensory Femoral fixation - A Case Report.

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction using hamstring tendon graft is a commonly performed orthopedic surgery. Lateral femoral condyle fracture through the femoral tunnel is a rare complication following ACL reconstruction. These cases are reported to be managed in two stages, fracture fixation by open reduction and internal fixation with bone grafting of the femoral tunnel, followed by revision ACL reconstruction after the fracture union.

CASE REPORT: A 41-year-old male Kabaddi player underwent right knee arthroscopic ACL reconstruction following an ACL tear in January 2021, sustained a road traffic accident 7 weeks later and developed a lateral femoral condyle fracture. The graft was intact and trapped into the fracture site making fracture reduction difficult. The graft was lax due to the fixed loop button being trapped in the fracture. The patient was treated in a single stage by arthroscopy assisted fracture reduction and fixation with ACL graft salvage and reinforced suspensory femoral graft fixation to plate suspensory fixation.

CONCLUSION: This case is a rare presentation of lateral condyle fracture after ACL reconstruction and both the issues are managed in a single stage with the help of detailed surgical planning, using utmost arthroscopy skills and keeping all the options of fixation devices ready on the table during the surgery.