Acute traumatic patellar dislocation

被引:104
作者
Duthon, V. B. [1 ]
机构
[1] Hop Univ Geneve, Unite Orthopedie & Traumatol Sport, Serv Chirurg Orthoped & Traumatol Appareil Moteur, CH-1211 Geneva 14, Switzerland
关键词
Patella; Dislocation; Acute; Traumatic; Treatment; SOFT-TISSUE RESTRAINTS; RETINACULAR COMPLEX INJURY; MR FINDINGS; KNEE; INSTABILITY; ANATOMY; GROOVE;
D O I
10.1016/j.otsr.2014.12.001
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20 flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. (C) 2014 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:S59 / S67
页数:9
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