Retrospective Study of Patellar Fractures and Damage of Accessory Soft Tissue Based on MRI

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Mar 11

PMID 38466690

Authors

Yi-Fan Hua

Yu-Rou Zhang

Li Guo

Affiliations

Soon will be listed here.

Abstract

Background: To better understand the pathophysiological mechanisms of patellar fractures, MRI was utilized to identify the imaging signs of various types of patellar fractures.

Methods: A retrospective study was performed using MRI images of 52 patients with patellar fractures. Observing the development of patellar and femoral morphology and the imaging manifestations of different fracture types, such as fracture displacement, and damage to accessory ligaments, tendons, and meniscus, type of joint cavity effusion, and damage to surrounding accessory bones were identified.

Results: There were 21 tangential fractures (40.4%), 8 transverse fractures (15.4%), 8 longitudinal fractures (15.4%), 4 oblique fractures (7.7%), and 11 comminuted fractures (21.2%) among the 52 patients with patellar fracture. Tangential fractures begin at a younger age than the other four forms of fractures. When tangential fractures were compared to other types of fractures, medial patellar retinaculum and anterior and posterior cruciate ligament injuries were statistically significant (P< 0.05). The detection rate of trochlear dysplasia, type II and type III patellar was higher in patients with tangential fractures than in other fractures.

Conclusions: Tangential fractures are less common to cause anterior and posterior cruciate ligament injuries than other types of fractures, but they are more likely to cause medial patellar retinaculum injuries.

References

Ciliberti F, Guerrini L, Gunnarsson A, Recenti M, Jacob D, Cangiano V . CT- and MRI-Based 3D Reconstruction of Knee Joint to Assess Cartilage and Bone. Diagnostics (Basel). 2022; 12(2). PMC: 8870751. DOI: 10.3390/diagnostics12020279. View

Cao L, Sun K, Yang H, Wang H, Zeng R, Fan H . Influence of Patellar Morphology Classified by Wiberg Classification on Knee Joint Function and Patellofemoral Tracking After Total Knee Arthroplasty Without Patellar Resurfacing. J Arthroplasty. 2021; 36(9):3148-3153. DOI: 10.1016/j.arth.2021.04.009. View

Gwinner C, Mardian S, Schwabe P, Schaser K, Krapohl B, Jung T . Current concepts review: Fractures of the patella. GMS Interdiscip Plast Reconstr Surg DGPW. 2016; 5:Doc01. PMC: 4717300. DOI: 10.3205/iprs000080. View

Pfirrmann C, Zanetti M, Romero J, Hodler J . Femoral trochlear dysplasia: MR findings. Radiology. 2000; 216(3):858-64. DOI: 10.1148/radiology.216.3.r00se38858. View

Kfuri M, Escalante I, Schopper C, Zderic I, Stoffel K, Sommer C . Comminuted patellar fractures: The role of biplanar fixed angle plate constructs. J Orthop Translat. 2020; 27:17-24. PMC: 7732873. DOI: 10.1016/j.jot.2020.10.003. View

Jirangkul P, Kosiyatrakul A . Abstaining from symptomatic implants of modified tension band wiring by nonabsorbable suture fixation for transverse patella fractures. J Orthop Surg Res. 2021; 16(1):367. PMC: 8188798. DOI: 10.1186/s13018-021-02494-3. View

Sanders T, Medynski M, Feller J, Lawhorn K . Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000; 20 Spec No:S135-51. DOI: 10.1148/radiographics.20.suppl_1.g00oc19s135. View

Kosy J, Matteliano L, Rastogi A, Pearce D, Whelan D . Meniscal root tears occur frequently in multi-ligament knee injury and can be predicted by associated MRI injury patterns. Knee Surg Sports Traumatol Arthrosc. 2018; 26(12):3731-3737. DOI: 10.1007/s00167-018-5009-0. View

Hargett D, Sanderson B, Little M . Patella Fractures: Approach to Treatment. J Am Acad Orthop Surg. 2021; 29(6):244-253. DOI: 10.5435/JAAOS-D-20-00591. View

10.

Vande Berg B, Lecouvet F, Poilvache P, Jamart J, Materne R, Lengele B . Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging. Radiology. 2002; 222(2):430-6. DOI: 10.1148/radiol.2222010597. View

11.

Maquet P . Fractures of the patella. J Bone Joint Surg Am. 1994; 76(10):1594. DOI: 10.2106/00004623-199410000-00023. View

12.

Zderic I, Stoffel K, Sommer C, Hontzsch D, Gueorguiev B . Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation. Injury. 2017; 48(8):1749-1757. DOI: 10.1016/j.injury.2017.05.037. View

13.

Lintin L, Chowdhury R, Yoong P, Chung S, Mansour R, Teh J . The anterolateral ligament in acute knee trauma: patterns of injury on MR imaging. Skeletal Radiol. 2020; 49(11):1765-1772. DOI: 10.1007/s00256-020-03446-4. View

14.

Thakkar R, Del Grande F, Wadhwa V, Chalian M, Andreisek G, Carrino J . Patellar instability: CT and MRI measurements and their correlation with internal derangement findings. Knee Surg Sports Traumatol Arthrosc. 2015; 24(9):3021-3028. DOI: 10.1007/s00167-015-3614-8. View

15.

Salonen E, Magga T, Sillanpaa P, Kiekara T, Maenpaa H, Mattila V . Traumatic Patellar Dislocation and Cartilage Injury: A Follow-up Study of Long-Term Cartilage Deterioration. Am J Sports Med. 2017; 45(6):1376-1382. DOI: 10.1177/0363546516687549. View

16.

Kakazu R, Archdeacon M . Surgical Management of Patellar Fractures. Orthop Clin North Am. 2015; 47(1):77-83. DOI: 10.1016/j.ocl.2015.08.010. View

17.

Sonin A, Fitzgerald S, Friedman H, Hoff F, Hendrix R, Rogers L . Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology. 1994; 190(2):455-8. DOI: 10.1148/radiology.190.2.8284399. View

18.

Wild M, Windolf J, Flohe S . [Fractures of the patella]. Unfallchirurg. 2010; 113(5):401-11. DOI: 10.1007/s00113-010-1768-x. View

19.

Cui B, Liu Y, Chen S . Analysis of Sports Knee Fractures Based on X-Ray and Computed Tomography Imaging. Comput Math Methods Med. 2021; 2021:9572363. PMC: 8654551. DOI: 10.1155/2021/9572363. View

20.

Nomura E, Inoue M, Kurimura M . Chondral and osteochondral injuries associated with acute patellar dislocation. Arthroscopy. 2003; 19(7):717-21. DOI: 10.1016/s0749-8063(03)00401-8. View