*Corresponding author:
Nam QD Vo, Hospital for Traumatology and Orthopaedics, HCM City, VietnamReceived: February 13, 2018; Published: February 21, 2018
DOI: 10.26717/BJSTR.2018.02.000784
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Patello femoral instability (PFI) is a debilitating injury for the patient and a challenging problem for the surgeon. The incidence of PFI ranges from 5.8 to 77.8 per 100,000 and recurrence rates of nonoperatively treated dislocations range from 15% to 50% [1]. In children and adolescents, the recent studies showed the incident of PFI of 43 per 100,000 [2] and the recurrent rates between 30% and 38% [2,3]. The medial patella femoral ligament (MPFL) is the primary soft-tissue restraint to lateral patellar translation [4]. The MPFL has a “sail-like” appearance with two functional portions: inferior straight bundle and superior oblique bundle. The MPFL originates from the medial femoral condoyle just proximal to the femoral attachment of the medial collateral ligament and distal to the adductor tubercle. It inserts on the super medial border of the patella. In children and adolescents with open phases, the femoral insertion is located slightly distal (4 to 5mm) to the medial femoral physics [5]. During 0 to 30 degrees of knee flexion, the MPFL contributes more than 60% of the medial stability of the patella and isolated insufficiency leads to increased lateralization or dislocation [6].
Abbreviations: M: Mature; I: Immature; IF: Isolated Femoral Attachment; IP: Isolated Patellar Insertion; MID: Isolated Mid-Substance; COM: Combined MPFL Injuries; C: Complete Tear; P: Partial Tear