{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:58:45Z","timestamp":1783511925414,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Accurate assessment of the locations of patellar avulsion fractures in acute patellar dislocations is clinically relevant for decision making for treatment. The study aim was to classify the locations of patellar avulsion fractures with a focus on the ligament attachments of medial stabilizing structures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Out of 131 first\u2010time acute traumatic patellar dislocations, 61 patients had patellar fractures. Subsequently, 10 patients with isolated osteochondral fractures of the articular surface in the patella were excluded. Finally, 51 patients (34 females and 17\u00a0males, average age: 18.5 years, 95% CI 16.1\u201320.9) were included in the study cohort. Based on the locations of the patellar attachment, the patients were divided into three groups: the superior group [medial patellofemoral ligament (MPFL) attachment], inferior group [medial patellotibial ligament (MPTL)\/medial patellomeniscal ligament (MPML) attachment], and mixed group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the patellar avulsion group (51 patients), the superior group, mixed group, and inferior group contained 8\/51 (16%), 12\/51 (24%), and 31\/51 (61%) patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed that 84% of the patellar avulsion fractures were located in the inferomedial patellar border, which consisted of MPTL\/MPML attachments that were clearly different from the true \u201cMPFL\u201d attachment at the superomedial patellar border. In terms of the clinical relevance, the acute surgical repair of MPTL\/MPML attachments in the inferomedial patellar border may not sufficiently control the patella if optimal management of the MPFL is not performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-05853-5","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T01:41:16Z","timestamp":1581558076000},"page":"3942-3948","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The majority of patellar avulsion fractures in first\u2010time acute patellar dislocations included the inferomedial patellar border that was different from the medial patellofemoral ligament attachment"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2565-0221","authenticated-orcid":false,"given":"Tomoharu","family":"Mochizuki","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine Niigata University Graduate School of Medical and Dental Science 1\u2010757 Asahimachi\u2010dori Chuo\u2010ku 951\u20108510 Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Tanifuji","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine Niigata University Graduate School of Medical and Dental Science 1\u2010757 Asahimachi\u2010dori Chuo\u2010ku 951\u20108510 Niigata 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951\u20108510 Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sato","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Niigata Medical Center Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Endo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine Niigata University Graduate School of Medical and Dental Science 1\u2010757 Asahimachi\u2010dori Chuo\u2010ku 951\u20108510 Niigata 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