RESUMO
Bipartite patella is a normal anatomic variant of patella. There are various data about the prevalence of bipartite patella in the literature. The aim of this study was to investigate its prevalence, type distribution and sex predilection in Turkish population. Bilateral knee radiographs were retrospectively reviewed of 897 consecutive adult patients. Cases with bipartite patella were categorized according to the Oohashi classification. Medical records were examined in order to differentiate symptomatic and asymptomatic bipartite patellae. We contacted symptomatic patients by telephone to learn continuity of knee pain. We identified 11 cases (7 male, 4 female) of bipartite patella among the 283 male and 614 female patients. No bilateral cases were identified. The prevalence of bipartite patella was 1.22% overall, 2.47% in males, and 0.65% in females. The most common type was superolateral bipartite patella as seen in 9 patients (81.8%). One subject had lateral bipartite and one subject had superolateral tripartite patella. Painful bipartite patella was found in only 2 patients (18%). One of them had continuing symptoms even after 12 months. In conclusion, we found that the prevalence of bipartite patella in Turkish population was approximately 1%. Both inclusion of only adult (skeletally mature) subjects and assessment with bilateral imaging increased the reliability of this value. In accordance with the literature, bipartite patella was found significantly more frequent in males and mostly in superolateral type. More studies are needed in order to obtain the prevalence, type and sex distribution of bipartite patella in different populations.
La patela bipartita es una variante anatómica normal. En la literaturahay varios datos sobre la prevalencia de patela bipartitae. El objetivo de este estudio fue investigar la prevalencia, distribución y aparición según sexo en la población turca. Se revisaron retrospectivamente radiografías bilaterales de rodilla de 897 pacientes adultos. Los casos con patela bipartita se clasificaron de acuerdo a la clasificación de Oohashi. Fueron examinados los registros médicos de los pacientes con el fin de diferenciar los casos de patela bipartita sintomática y asintomática. Se estableció contacto con los casos sintomáticos por teléfono para conocer la continuidad del dolor de rodilla. Se identificaron 11 casos (7 varones, 4 mujeres) de patela bipartita entre 283 hombres y 614 pacientes de sexo femenino. No se identificaron casos bilaterales. La prevalencia de patela bipartita fue de 1,22% en total, 2,47% en varones y 0,65% en las mujeres. El tipo más común fue la patela bipartita superolateral en 9 pacientes (81,8%). Un sujeto presentó patela bipartita lateral y en otro caso, patela tripartita superolateral. La patela bipartita dolorosa fue encontrada en sólo 2 pacientes (18%). Uno de ellos presentó síntomas que continuaron incluso después de 12 meses. En conclusión, se encontró que la prevalencia de la patela bipartita en la población turca fue de aproximadamente un 1%. La inclusión en esta investigación de solo sujetos adultos (con el esqueleto maduro) y el estudio de imágenes bilaterales aumentó la fiabilidad de estos parámetros. De acuerdo con la literatura, la patela bipartita se encontró significativamente de manera más frecuente en hombres y en su mayoría se trató del tipo superolateral. Se necesitan más estudios para obtener la prevalencia, tipo y distribución por sexo de la patela bipartita en diferentes poblaciones.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Variação Anatômica , Joelho/anormalidades , Joelho/diagnóstico por imagem , Patela/anormalidades , Patela/diagnóstico por imagem , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Turquia/epidemiologiaRESUMO
The purpose of this retrospective study was to compare the outcomes and complications of conventional open surgical release and percutaneous needle release in the treatment of trigger thumb. The study comprised 87 patients with trigger thumb who were treated with either open pulley (n=52) or percutaneous (n=32) release between 2008 and 2011. All patients were reevaluated at a mean follow-up of 22.7±9.6 months (range, 9-44 months). Main outcome measures were the rate of recurrence, pain on movement or tenderness over the pulley, infection rate, digital nerve injury, tendon bowstringing, joint stiffness or loss of thumb range of motion, and patient satisfaction. The groups were statistically similar regarding age, sex, laterality, dominant side involvement, and trigger thumb grade on initial admission. At final follow-up, no patient had recurrence, tendon bowstringing, joint stiffness, or loss of thumb range of motion. No patients in the open pulley release group and 2 (5.7%) patients in the percutaneous release group had a digital nerve injury (P=.159). No statistical difference was found in the infection rate between groups (P=.354). A total of 98.1% of patients in the open pulley release group and 97.1% of patients in the percutaneous release group were satisfied with treatment (P=.646). Both techniques resulted in similar therapeutic efficacy, and the rate of potential complications was also statistically similar in each group. Although statistically insignificant, the authors believe that the 5.7% rate of iatrogenic digital nerve injury seen in the percutaneous release group is clinically significant and serious. Therefore, they advocate using open surgical release of trigger thumb.
