Kumar Deepak, Sn Lokesh, Sodavarapu Praveen, Khan Shahnawaz, Rathod Pratik M
Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, IND.
Orthopaedics, Employees' State Insurance Corporation Hospital, Chennai, IND.
Cureus. 2020 Apr 4;12(4):e7533. doi: 10.7759/cureus.7533.
Distal femur fractures in younger age groups are associated with high-impact injury leading to severe comminution and soft tissue injuries. Most of the intra-articular distal femur fractures occur as a result of axial loading accompanied by a variable amount of flexion. An 18-year-old male patient who had met with a road traffic accident was brought to the trauma center. Radiographic examination revealed a fracture of the distal femur, predominantly involving the lateral condyle without any evidence of metaphyseal comminution, and lateral view showed a complete separation of both the condyles from the proximal shaft. This type of fracture pattern did not fit into any of the current classification systems of distal femoral fractures. The medial and lateral approaches were carried out simultaneously instead of the anterior midline approach, owing to the poor skin condition over the anterior aspect of the knee. These fractures are difficult to treat due to high articular involvement and present a tedious task for the surgeon. Anatomical reduction with preserved articular cartilage is the key to a good outcome in such complex fractures. Atypical fracture types are not uncommon, and they can be incorporated into existing or future classification systems, which may contribute to a better understanding and management of these fractures.
年轻人群的股骨远端骨折与高能量损伤相关，常导致严重粉碎性骨折和软组织损伤。大多数股骨远端关节内骨折是轴向负荷伴不同程度屈曲所致。一名18岁男性因道路交通事故被送至创伤中心。影像学检查显示股骨远端骨折，主要累及外侧髁，无干骺端粉碎迹象，侧位片显示双侧髁与近端骨干完全分离。这种骨折类型不符合目前任何股骨远端骨折分类系统。由于膝关节前方皮肤条件差，未采用前正中切口，而是同时进行了内侧和外侧入路。这些骨折因关节受累严重而难以治疗，对外科医生来说是一项繁琐的任务。保留关节软骨的解剖复位是此类复杂骨折获得良好预后的关键。非典型骨折类型并不罕见，可纳入现有或未来的分类系统，这可能有助于更好地理解和处理这些骨折。
