Patterns of Avulsion and Osteochondral Fractures Associated with Patellar Dislocations: A Descriptive Study Using...

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomedical Imaging

Background:

• Patellar dislocations frequently cause avulsion and osteochondral fractures.
• Accurate fracture pattern identification is crucial for effective treatment.

Purpose of the Study:

• To analyze avulsion and osteochondral fractures associated with patellar dislocation.
• To categorize fracture patterns using 3D computed tomography (CT).

Main Methods:

• Retrospective analysis of 148 patients (160 knees) with patellar dislocations (2015-2023).
• Evaluation of 3D CT scans by a musculoskeletal radiologist and orthopedic surgeons.
• Classification of fractures into five distinct patterns (I-V) based on ligamentous or osteochondral involvement.

Main Results:

• 116 patients (72.5%) had fractures; Pattern II (medial patellotibial/medial patellomeniscal ligament avulsion) was most prevalent (41.2%).
• Pattern I (MPFL avulsion) and Pattern III (inferomedial patellar facet fracture) were also common.
• Osteochondral fragments were frequently found in the lateral gutter and anterior joint space.

Conclusions:

• Identified five distinct fracture patterns in patellar dislocations using 3D CT.
• Medial patellotibial/medial patellomeniscal ligament injuries are more common than previously believed.
• Highlights the need for a comprehensive diagnostic approach for patellar dislocation injuries.