1. The majority of patellar avulsion fractures in first-time acute patellar dislocations included the inferomedial patellar border that was different from the medial patellofemoral ligament attachment
- Author
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Osamu Tanifuji, Satoshi Watanabe, Takashi Sato, Tomoharu Mochizuki, Y. Tomiyama, Ryota Katsumi, and Naoto Endo
- Subjects
musculoskeletal diseases ,Male ,medicine.medical_specialty ,Medial patellotibial ligament ,Adolescent ,Patellar Dislocation ,Patellar Dislocations ,Medial patellofemoral ligament ,Avulsion ,03 medical and health sciences ,Patellofemoral Joint ,Young Adult ,0302 clinical medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,030222 orthopedics ,Patellar border ,business.industry ,030229 sport sciences ,Patella ,musculoskeletal system ,Surgery ,medicine.anatomical_structure ,Fractures, Avulsion ,Orthopedic surgery ,Ligaments, Articular ,Ligament ,Female ,business ,human activities - Abstract
Accurate assessment of the locations of patellar avulsion fractures in acute patellar dislocations is clinically relevant for decision making for treatment. The study aim was to classify the locations of patellar avulsion fractures with a focus on the ligament attachments of medial stabilizing structures. Out of 131 first-time acute traumatic patellar dislocations, 61 patients had patellar fractures. Subsequently, 10 patients with isolated osteochondral fractures of the articular surface in the patella were excluded. Finally, 51 patients (34 females and 17 males, average age: 18.5 years, 95% CI 16.1–20.9) were included in the study cohort. Based on the locations of the patellar attachment, the patients were divided into three groups: the superior group [medial patellofemoral ligament (MPFL) attachment], inferior group [medial patellotibial ligament (MPTL)/medial patellomeniscal ligament (MPML) attachment], and mixed group. In the patellar avulsion group (51 patients), the superior group, mixed group, and inferior group contained 8/51 (16%), 12/51 (24%), and 31/51 (61%) patients, respectively. This study showed that 84% of the patellar avulsion fractures were located in the inferomedial patellar border, which consisted of MPTL/MPML attachments that were clearly different from the true “MPFL” attachment at the superomedial patellar border. In terms of the clinical relevance, the acute surgical repair of MPTL/MPML attachments in the inferomedial patellar border may not sufficiently control the patella if optimal management of the MPFL is not performed. IV.
- Published
- 2019