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  • 1
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Clinical Orthopaedics & Related Research Vol. 475, No. 6 ( 2017-06), p. 1583-1591
    In: Clinical Orthopaedics & Related Research, Ovid Technologies (Wolters Kluwer Health), Vol. 475, No. 6 ( 2017-06), p. 1583-1591
    Type of Medium: Online Resource
    ISSN: 0009-921X
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2018318-5
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  • 2
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 44, No. 11 ( 2016-11), p. 2833-2837
    Abstract: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis. Purpose: To evaluate the relationship of the distal femoral physis and the MPFL. Study Design: Descriptive laboratory study. Methods: In 15 cadaveric, pediatric knees (age, 7-11 years), markers were placed at the proximal/distal limits of the MPFL femoral attachment and were evaluated with computed tomography. The distance from the MPFL attachment midpoint to the most medial aspect of the distal femoral physis was measured. Results: The mean femoral width of the MPFL was 8.1 mm (range, 4.3-13.8 mm). The femoral MPFL midpoint was distal to the femoral physis in 11 specimens and proximal to the physis in 4 specimens. The most proximal portion of the MPFL femoral attachment extended above the medial physis in 7, was at the physis in 5, and was below the physis in 3 specimens. One specimen had the entire MPFL femoral attachment above the physis. For knees with the MPFL midpoint above the medial physis, the distance between the center of the MPFL and physis was 3.3 mm (range, 0.3-7.1 mm). For knees with the MPFL below the medial physis, the distance between the center of the MPFL and physis was −6.8 mm (range, −0.7 to −22.0 mm). Conclusion: The relationship of the femoral attachment of the MPFL and the medial femoral physis shows some anatomic variation. In all cases, the MPFL is close to the medial femoral physis, but the midpoint of the MPFL is at, slightly above, or slightly below the physis. Clinical Relevance: The relationship of the MPFL femoral attachment footprint to the femoral physis in the skeletally immature patient is not well understood, and access to pediatric cadaveric tissue is very limited. This small series demonstrates that there is considerable variation in the relationship between the MPFL and distal femoral physis. This anatomic information may guide MPFL reconstruction technique in young patients and reduce the risk of iatrogenic physeal arrest on the femur.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Pediatric Orthopaedics Vol. 38, No. 2 ( 2018-02), p. e38-e42
    In: Journal of Pediatric Orthopaedics, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 2 ( 2018-02), p. e38-e42
    Abstract: Tibial spine avulsions (TSA) have historically been treated as isolated injuries. Data on associated injuries are limited with existing literature reporting wide ranging incidences. The purpose of this multicenter study was to (1) describe the incidence of meniscal entrapment and associated knee injuries in TSA and to (2) compare surgical and magnetic resonance image (MRI) findings for these injuries. Our hypothesis is that tibial spine injuries are not usually isolated injuries, and other meniscal, ligament, and cartilage injuries may be present. Methods: MRI and surgical reports for patients with a diagnosis of a tibial spine fracture were retrospectively reviewed. Type of fracture was recorded as noted in the reports along with concomitant meniscal entrapment and osteochondral, ligamentous, and meniscal injury. Images and reports were reviewed by an orthopaedic surgeon at each respective institution. Results: A total of 163 patients were included in this study. MRI was done for 77 patients and surgery was performed in 144 cases. Meniscal entrapment was found in 39.9% of all patients. MRI diagnosed meniscus, osteochondral, and non-anterior cruciate ligament ligamentous injury was found in 31.2%, 68.8%, and 32.4% of cases, respectively. Surgically diagnosed meniscus, chondral, and non-anterior cruciate ligament ligamentous injury was found in 34.7%, 33.3%, and 5.6% of patients, respectively. Conclusions: TSA fractures are associated with significant risk for concomitant knee injuries including meniscal tear, bone contusion, and chondral injury. Incidence of meniscal entrapment found during surgery was high, in spite of low incidence of positive findings by MRI. Level of Evidence: Level IV—retrospective case series.
    Type of Medium: Online Resource
    ISSN: 0271-6798
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2049057-4
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