Medial femoral condyle fracture associated with lipohaemarthrosis and lateral patellar dislocation

Case contributed by Dr Bruno Di Muzio

Presentation

Motorcycle accident.

Patient Data

Age: 23
Gender: Male

Lateral femoral condyle fracture and lipo haemarthrosis.

Lytic well-defined bone lesion eccentric located in the distal femoral epiphysis, measuring up to 3.0 cm, sharply defined margins, with apparently internal arch calcifications, and no periosteal reaction. Features are those of a nonaggressive bone tumour. 

 

Medial femoral condyle fracture associated with lipohaemarthrosis. Diffuse subcutaneous oedema. 

 

There is a undisplaced longitudinal irregular fracture line through the medial femoral condyle and associated with bone marrow oedema. Large lipohaemarthrosis.

The medial patellar retinaculum is torn and the patella mildly lateral displaced.

MCL is normal.

Adductor tendon is normal but there is injury to the VMO.The menisci are intact. Anterior cruciate ligament intact The posterior cruciate ligament is intact. Collateral ligaments are intact.

Posterolateral ligaments are preserved.

The quadricipital tendon and patellar ligament are preserved.

Diffuse soft tissue oedema.

Dash line delineating the levels between the haemarthrosis and the lipidic content (blue star), on the MRI it is possible also to note the dependent layering of the cellular component of the haemarthrosis (red star). 

Case Discussion

Traffic accidents involving motorcycles can produce a variety of musculoskeletal injuries, sometimes with no clear mechanism of injury. 

This case demonstrates a nondisplaced fracture involving the medial femoral condyle associated with a torn medial patellar retinaculum and injured vastus medialis, which together cause a lateral patellar dislocation. Prominent lipo haemarthrosis is present and seen in all the images (X-ray, CT, and MRI). 

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Case information

rID: 45726
Case created: 6th Jun 2016
Last edited: 11th Oct 2016
Tag: rmh
Inclusion in quiz mode: Included

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