Use of flotation cast in a competitive swimmer with osteochondritis dissecans of lateral femoral condyle

Abstract

A 14 year old female swimmer of international caliber developed osteochondritis dissecans of the left lateral femoral condyle. At her age, conservative orthopedic management recommended non weight bearing immobilization of the left knee for 6 months. The removal of this athlete from competitive swimming for that period of time would have prevented her from representing Canada at the 1970 Commonwealth Games and would have seriously challenged her future in this sport. To facilitate her continued training and participation during treatment, a durable waterproof flotation cylinder cast was designed. The expanded polyethylene lining of the cast was molded to her leg and then finished with fiberglass as a reinforced exterior. This method of immobilization allowed the athlete to continue her training program of 2 to 5 hours per day from December 1969 to May 1970 even though she utilized crutches except while swimming. Ten weeks after removal of the cast, and with radiological demonstration of reincorporation of the fragment in the lateral femoral condyle, this athlete won silver and bronze medals at the 1970 Commonwealth Games.