التفاصيل البيبلوغرافية
| العنوان: |
Clinical and Radiographic Differentiation of Pediatric Patellar Sleeve Fractures and Other Inferior Pole Pathologies. |
| المؤلفون: |
Devana, Sai K., Trivellas, Andromahi, Bennett, Abbie, Jackson, Nicholas, Beck, Jennifer J. |
| المصدر: |
American Journal of Sports Medicine; Mar2022, Vol. 50 Issue 4, p977-983, 7p |
| مصطلحات موضوعية: |
KNEE radiography, KRUSKAL-Wallis Test, ACADEMIC medical centers, ANALYSIS of variance, SINDING-Larsen-Johansson syndrome, CROSS-sectional method, CHILDREN'S hospitals, PEDIATRICS, RETROSPECTIVE studies, ACQUISITION of data, FISHER exact test, MANN Whitney U Test, PATELLA fractures, URBAN hospitals, T-test (Statistics), MEDICAL records, DESCRIPTIVE statistics, ELECTRONIC health records, DATA analysis software, KNEE, SYMPTOMS |
| مصطلحات جغرافية: |
UNITED States |
| مستخلص: |
Background: Inferior pole patellar sleeve fractures (PSFs) are rare injuries that occur in skeletally immature patients that may be missed or falsely diagnosed as an inferior pole fracture (IPF) or Sinding-Larsen-Johansson syndrome (SLJS). Purpose: The objective of this study was to evaluate and compare clinical and radiographic features of patients with PSF, IPF, and SLJS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Retrospective review of skeletally immature patients diagnosed with PSF, IPF, and SLJS between 2011 and 2019 at a single urban academic center was performed. Chart and radiographic review was completed. Between-group differences were assessed using analysis of variance, Kruskal-Wallis test, and Fisher exact test, as appropriate to variable distributions. Results: In total, 125 patients (82% male) were included, with a mean (SD) age of 10.7 (2) years (16 PSF, 51 IPF, 58 SLJS). There were no significant differences in patient characteristics between the 3 groups. One hundred percent of the patients with PSF (P <.001) and IPF (P <.001) had acute trauma, compared with 24% of patients with SLJS. Fewer patients with PSF had an intact straight leg raise (38%) compared with those with IPF (94%; P <.001) and SLJS (98%; P <.001). Fewer patients with SLJS had knee swelling (41%) compared with those with PSF (93%; P <.001) and IPF (94%; P <.001). More patients with PSF had knee effusion (81%) compared with those with IPF (37%; P = 0.011) and SLJS (3%; P <.001). More patients with SLJS were able to bear weight (88%) compared with those with IPF (12%; P <.001) and PSF (0; P <.001). Radiographically, compared with those with IPF and SLJS, patients with PSFs had increased mean prepatellar swelling (6.1 [ P <.001] and 6.5 [ P <.001] vs 12.9 mm), intra-articular effusion (6.1 [ P =.014] and 4.9 [ P =.001] vs 9.2 mm), maximum fragment size (26 [ P =.004] and 17.7 [ P <.001] vs 45.3 mm), and maximum fragment displacement (1.24 [ P =.002] and 1.45 [ P =.003] vs 13.30 mm), respectively. Compared with those with SLJS (1.10), patients with PSF (1.92; P <.001) and IPF (1.22; P <.001) had patella alta with higher mean Insall-Salvati ratios >1.2. Conclusion: Differences in clinical features such as ability to straight leg raise, knee swelling, knee effusion, ability to bear weight, and radiographic features, such as prepatellar swelling, intra-articular effusion, fragment displacement/size/shape/location, and patellar height, can all be helpful in recognizing rare pediatric inferior patellar pathology, thus increasing efficiency in indicating for higher-level imaging to reach a prompt diagnosis and provide appropriate treatment. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
