Acute traumatic patellar dislocation with periarticular injuries in children: A retrospective study of 137 patients.

Abstract

Objective: We endeavor to investigate the incidence and treatment of acute traumatic patellar dislocation (PD) in conjunction with various knee joint injuries in children.

Methods: A retrospective analysis was conducted on 137 patients diagnosed with acute traumatic PD and associated periarticular injuries. Patient imaging examinations, medical histories, and treatment records were collected and analyzed to assess the occurrence of PD in combination with injuries to the surrounding knee joint tissues, and to explore effective treatment strategies.

Results: Among the patients studied: 1 had a quadriceps injury, 6 had peripheral ligament injuries, 31 had avulsion fractures of the medial border of the patella, 7 had fractures of the lateral femoral condyle, 2 had fractures of the medial femoral condyle,5 had tibial tubercle fractures, 43 had cartilage injuries. Several patients presented with multiple injuries. In cases where only medial patellofemoral ligament (MPFL) injury occurred: 13 patients underwent MPFL reconstruction, none of whom experienced re-dislocation post-surgery. 29 patients underwent non-surgical treatment, with 12 experiencing at least one re-dislocation afterward. Overall: 92 patients received non-surgical treatment, with 30 patients experiencing re-dislocation post-surgery, resulting in a re-dislocation rate of 32.61 %. 45 patients underwent surgical treatment, with only 1 patient experiencing re-dislocation post-surgery, yielding a recurrence rate of 2.22 %.

Conclusion: Traumatic PD in children often involves significant soft tissue and bone damage. Surgical intervention is particularly beneficial when combined with extensor mechanism injuries, cartilage damage, or large fractures, as it effectively reduces the recurrence rate of postoperative dislocations.