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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2023; 64(01): e36-e42
DOI: 10.1055/s-0042-1748932
Artículo Original | Original Article

Injury Pattern on Magnetic Resonance Imaging of First-time Patellar Dislocations in Children and Adolescents

Article in several languages: español | English

Authors

  • María Tuca

    1   Departamento de Cirugía Ortopédica, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile

  • Tomás Pineda 

    2   Departamento de Cirugía Ortopédica, Hospital El Carmen, Santiago, Chile

  • Mauricio Nuñez

    3   Departamento de Cirugía Ortopédica, Instituto de Seguridad del Trabajador, Santiago, Chile

  • Nicolás Zilleruelo

    1   Departamento de Cirugía Ortopédica, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile

  • Cristián Olmedo

    1   Departamento de Cirugía Ortopédica, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile

  • David Figueroa

    1   Departamento de Cirugía Ortopédica, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile


Funding The authors declare that the present research did not receive any specific grant.
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Abstract

Objective To characterize medial patellofemoral ligament (MPFL) lesions and osteochondral lesions after a first episode of lateral patellar dislocation (LPD) in young patients.

Methods We evaluated 91 magnetic resonance imaging scans from patients under 18 years of age (average age: 14.5 years), with a first episode of LPD, from a single pediatric emergency center, between 2008 and 2012. The location and extension of the MPFL lesions and the location and size of the osteochondral lesions were analyzed.

Results We found MPFL injuries in 49.5% (45) of the cases. Total and partial ruptures of the MPFL were found in 10.9% (10) and 39.5% (36) of the patients respectively. Among the total ruptures, 70% (7) occurred in the patellar insertion, 20% (2), in the femoral insertion, and 10% (1) were multifocal. Of the partial injuries, 72% (26) were patellar, 19.4% (7), femoral, and 8.3% (3), multifocal. Osteochondral lesions were found in 38% (35) of the patients; 62.8% (22) were located in the patella, and 34.2% (12), in the lateral femoral condyle, while only 3% (1) were multifocal.

Conclusion Half of the cases presented MPFL injuries. Partial MPFL injuries at the patellar attachment are the most common pattern in skeletally-immature patients suffering an LPD for the first time. More than one third of the cases of first-time LPD in children will present a concomitant osteochondral injury, mostly at the patella.

Level of Evidence Level III.

adolescents

Keywords

lateral patellar dislocation - medial patellofemoral ligament - osteochondral injury - children - adolescents


Publication History

Received: 18 January 2022

Accepted: 15 March 2022

Article published online:
24 June 2022

© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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