Medial femoral condyle fracture associated with lipohemarthrosis 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 hemarthrosis.

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 tumor. 

 

Medial femoral condyle fracture associated with lipohemarthrosis. Diffuse subcutaneous edema. 

 

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

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 edema.

Dash line delineating the levels between the hemarthrosis and the lipidic content (blue star), on the MRI it is possible also to note the dependent layering of the cellular component of the hemarthrosis (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 hemarthrosis is present and seen in all the images (X-ray, CT, and MRI). 

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Case information

rID: 45726
Published: 7th Jun 2016
Last edited: 16th Jul 2018
Tag: rmh
Inclusion in quiz mode: Included

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