case_images: PMC11437560_01
case_images: The figure shows the combination of multiple non-contiguous fractures of the left femur: displaced intracapsular fracture of the left femur (AO 31B2), a left diaphyseal multifragmentary fracture (AO 32B3), a supradiacondylar fracture of the distal end of the left femur (AO 33C1.1), a Hoffa fracture of the lateral left femoral condyle (AO 33B3.2 f), and a multifragmentary fracture of the left patella with bone loss (AO 34C3).
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case_images: The patient sustained a blunt chest injury, a non-concussive head injury, a displaced intracapsular fracture of the left femur (AO 31B2), a left diaphyseal multifragmentary fracture (AO 32B3), a supradiacondylar fracture of the distal end of the left femur (AO 33C1.1), a Hoffa fracture of the lateral left femoral condyle (AO 33B3.2 f), and a multifragmentary fracture of the left patella with bone loss (AO 34C3) (Figure 1) (Table 1).
case_images: The post-operative X-ray: an 11-hole less invasive stabilization system plate and screws, a 3.5-mm anteroposterior screw, 6.5-mm cannulated screws for the femoral neck, and intercondylar fracture fixation were used.
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case_images: Finally, by using the same anterolateral knee approach, the patella was fixed by a dynamic tension band wiring technique, free 1.8 K wires for small fragments and a non-absorbable wire circumferential cerclage (Figure 2).
case_images: The figure shows the fractures healing and the removal of the patellar tension banding cerclage wire, condylar cannulated screws, and distal less invasive stabilization system condylar screws.
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case_images: At 16 months, the patient underwent patellar tension banding removal following complaints related to prominent hardware and discomfort; a prominent free intercondylar cannulated screw and distal LISS screws were also removed in that surgical procedure (Figure 3).
case_images: The figure shows the X-rays after hardware removal 24 months after the original trauma.
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case_images: At the 32-month follow-up, the Oxford Knee Score was 48 and the Harris Hip Score was 96, the patient presented no avascular necrosis of the femoral head, walked without crutches and had a full knee range of motion (ROM) (0 -135 ) and full hip ROM (Figure 4) with no signs of knee instability.
case_images: Clinical results at the last follow-up visit (32 months).
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case_images: No radiological signs of degenerative arthritis were observed at the last X-ray examination of the knee joint and all the fractures healed uneventfully. (Figure 5).
case_images: PRISMA flowchart for literature review.
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case_images: A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart was reported (Figure 6).