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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Related Experiment Video

Updated: May 30, 2025

Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
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Osteochondral Fractures in Adolescents With First-time Patellar Dislocation: Three-dimensional Characterization and

Annmarie Wang1, Beltran Torres-Izquierdo1, Jeffrey J Nepple1

  • 1Washington University in St Louis, Saint Louis, Missouri, USA.

The American Journal of Sports Medicine
|January 29, 2025
PubMed
Summary

Osteochondral fractures in pediatric patellar dislocations are common in the femur but larger on the patella. Anatomical factors and ligament laxity influence fracture patterns in young patients.

Keywords:
anatomybiomechanics, generalknee, patella

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Sports medicine

Background:

  • Osteochondral fractures from patellar dislocation can severely impact young patients.
  • Precise characterization of these fractures (location, size, frequency, radiographic associations) is lacking in pediatric and adolescent populations.

Purpose of the Study:

  • To define the topographic characteristics of osteochondral fractures in pediatric and adolescent patients experiencing their first patellar dislocation.
  • To investigate the relationship between these fracture characteristics and radiographic/patient factors.

Main Methods:

  • Retrospective observational study (2015-2023) of pediatric patients (<18 years) with displaced osteochondral fractures and first-time patellar dislocation.
  • Three-dimensional fracture mapping using heat map analysis; subgroup analysis of fracture size and location.
  • Statistical analysis included chi-square and independent t-tests (alpha = .05).

Main Results:

  • 82 knees (80 patients) with first-time patellar dislocation and osteochondral fracture were analyzed (97 fractures total).
  • Lateral femur was the most common fracture site (55%), followed by the patella (43%).
  • Patellar fractures were significantly larger (258 mm² vs 126 mm²) and more amenable to fixation than femoral fractures.

Conclusions:

  • The femur is the most frequent site of osteochondral fractures in pediatric patellar dislocations, but patellar fractures are significantly larger.
  • Anatomical structure and ligamentous laxity appear to be key factors influencing the patterns of these injuries.