An Unusual Ipsilateral Hip and Knee Trauma: Rotational Patellar Dislocation Incarcerated Between Femoral Condyles with Medial Femoral Condyle Fracture and Fracture-Dislocation of the Hip.

Abstract

Ipsilateral fractures and dislocations involving the hip, distal femur, and patella are rare and pose significant management challenges. We present a unique case of a 50-year-old male who sustained a posterior hip dislocation with femoral head fracture, medial femoral condyle fracture, and rotational patellar dislocation incarcerated between the femoral condyles following a high-energy roadside accident. The patient presented with limb deformity and a knee wound within 30 min post-injury. Initial closed reduction attempts failed, and surgical intervention under spinal anaesthesia achieved hip reduction via the Allis manoeuvre, open fixation of the distal femur fracture, and patellar relocation. Postoperative recovery was uneventful, with satisfactory joint function at five months. However, at 20 months, the patient developed avascular necrosis with osteoarthritic changes for which total hip replacement was advised. This case highlights the importance of prompt diagnosis and coordinated surgical management of complex lower-limb trauma.