A rare combination of sagittal fracture of the medial femoral condyle (Trélat fracture) with an ipsilateral femoral shaft fracture: A case report

Abstract

IntroductionIsolated unicondylar fractures of the distal femur are rare injuries, accounting for 3–6 % of adult femur fractures. The association with a femoral shaft fracture is very rare and, to our knowledge, has, never been described in the literature. Case presentationIn this article, we report the case of a 19-year-old motorcyclist involved in an accident, that resulted in both a midshaft transverse femoral fracture and an ipsilateral sagittal fracture of the medial femoral condyle (Trélat fracture). Clinical discussionThe surgical intervention involved open reduction and internal fixation for both fractures, utilizing a dynamic compression plate for the femoral shaft fracture and screws for the medial condyle fracture. Postoperative results showed excellent fracture reduction, and the patient progressed well with rehabilitation. The choice of fixation method for the sagittal medial femoral condyle fracture considered the unique anatomical challenges posed by this rare combination, the emergency (fat embolism), and the fact we didn't have a retrograde nail in our structure. A dynamic compression plate was used for femoral shaft fracture and screw fixation for condyle fracture treatment. The traction table in anterograde femoral nailing, led to the recurvatum of the condylar fracture and difficulty accessing it with the medial subvastus approach. ConclusionThis case report adds a description of a rare combination and valuable insight into the management of complex femoral fractures, emphasizing the importance of individualized treatment approaches.