case_images: PMC3504239_01
case_images: Preoperative X-ray of the right knee AP and lateral views showing fracture distal femur and proximal tibia.
case_images: CRIM.ORTHOPEDICS2012-913230.001.jpg
case_images: PMC3504239_01_CRIM.ORTHOPEDICS2012-913230.001.jpg
case_images: fig1
case_images: X-ray of the right knee revealed fracture distal femur OTA A3 and fracture proximal tibia OTA A2 (Figure 1). 
case_images: Fracture distal femur being fixed with DCS by MIPO.
case_images: CRIM.ORTHOPEDICS2012-913230.002.jpg
case_images: PMC3504239_01_CRIM.ORTHOPEDICS2012-913230.002.jpg
case_images: fig2
case_images: DCS fixation by bridge plating technique for the distal femur and lateral buttress plating by MIPO technique for proximal tibia were planned and executed under spinal anesthesia with image intensifier (Figure 2).
case_images: Intraoperative picture showing torn ends of patellar tendon.
case_images: CRIM.ORTHOPEDICS2012-913230.003.jpg
case_images: PMC3504239_01_CRIM.ORTHOPEDICS2012-913230.003.jpg
case_images: fig3
case_images: We were surprised to find the torn patellar tendon (Figure 3) along with avulsion of VMO from the medial border of patella and torn MPFL (Figure 4). 
case_images: Patella tilted 90  laterally (white arrow points to articular surface) to show the bare medial border (green arrow) from where VMO and MPFL were torn.
case_images: CRIM.ORTHOPEDICS2012-913230.004.jpg
case_images: PMC3504239_01_CRIM.ORTHOPEDICS2012-913230.004.jpg
case_images: fig4
case_images: We were surprised to find the torn patellar tendon (Figure 3) along with avulsion of VMO from the medial border of patella and torn MPFL (Figure 4). 
case_images: Patellar tendon repaired and protected with a figure of 8 wiring.
case_images: CRIM.ORTHOPEDICS2012-913230.005.jpg
case_images: PMC3504239_01_CRIM.ORTHOPEDICS2012-913230.005.jpg
case_images: fig5
case_images: The patellar tendon was protected by a figure of 8 tension band through patella and tibial tuberosity (Figure 5).
case_images: X-ray right leg AP and lateral views at 2-year followup showing fracture union.
case_images: CRIM.ORTHOPEDICS2012-913230.008.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.008.jpg
case_images: fig8
case_images: Weight bearing was allowed after radiological union of both the fractures after 3 months. 90 degrees of knee flexion was achieved by 6 months and the figure of 8 TBW was removed at that time (Figure 6). At 2-year followup, the patient has got a stable knee with the ROM of 0 to 100 degrees without any extensor lag or lateral patellar subluxation (Figures 7, 8, 9, and 10).
case_images: PMC3504239_02
case_images: 3-month followup X-ray of the right knee AP showing fracture union.
case_images: CRIM.ORTHOPEDICS2012-913230.006.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.006.jpg
case_images: fig6
case_images: Weight bearing was allowed after radiological union of both the fractures after 3 months. 90 degrees of knee flexion was achieved by 6 months and the figure of 8 TBW was removed at that time (Figure 6).
case_images: X-ray right femur AP and lateral views at 2-year followup showing fracture union.
case_images: CRIM.ORTHOPEDICS2012-913230.007.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.007.jpg
case_images: fig7
case_images: At 2-year followup, the patient has got a stable knee with the ROM of 0 to 100 degrees without any extensor lag or lateral patellar subluxation (Figures 7, 8, 9, and 10).
case_images: X-ray right leg AP and lateral views at 2-year followup showing fracture union.
case_images: CRIM.ORTHOPEDICS2012-913230.008.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.008.jpg
case_images: fig8
case_images: Weight bearing was allowed after radiological union of both the fractures after 3 months. 90 degrees of knee flexion was achieved by 6 months and the figure of 8 TBW was removed at that time (Figure 6). At 2-year followup, the patient has got a stable knee with the ROM of 0 to 100 degrees without any extensor lag or lateral patellar subluxation (Figures 7, 8, 9, and 10).
case_images: Clinical picture at 2-year followup after figure of 8 wire removal showing active SLR.
case_images: CRIM.ORTHOPEDICS2012-913230.009.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.009.jpg
case_images: fig9
case_images: At 2-year followup, the patient has got a stable knee with the ROM of 0 to 100 degrees without any extensor lag or lateral patellar subluxation (Figures 7, 8, 9, and 10).
case_images: Clinical picture at 2-years followup after figure of 8 wire removal showing knee flexion up to 100 .
case_images: CRIM.ORTHOPEDICS2012-913230.010.jpg
case_images: PMC3504239_02_CRIM.ORTHOPEDICS2012-913230.010.jpg
case_images: fig10
case_images: At 2-year followup, the patient has got a stable knee with the ROM of 0 to 100 degrees without any extensor lag or lateral patellar subluxation (Figures 7, 8, 9, and 10).