MULTILIGAMENT KNEE RECONSTRUCTION FOLLOWING COMPLEX DISTAL FEMUR INTRAARTICULAR FRACTURE - CASE REPORT.

Singhi, Prahalad Kumar; Amutham Elangovan, Ajay Gowtham; Raju, Sivakumar; Murugan, Silambarasan · J ISAKOS · 2026

case_report · Level V

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Abstract

Multiple-ligament injuries of the knee (MLKI), although rare (0.02-0.2% of all orthopaedic injuries), are often devastating. The management of MLKI is intricate and technically demanding often necessitating a staged approach. In polytrauma situations, MLKI poses considerable challenges to the operating surgeon, especially when combined with complex intra-articular fractures. Accurate initial diagnosis under these circumstances can be difficult, underscoring the in-depth understanding of knee anatomy and injury mechanism for early detection. Furthermore, the presence of multiple fixation devices adds complexity. Our patient underwent Multi-ligament reconstruction of ACL (Anterior cruciate ligament), PCL (Posterior cruciate ligament) and PLC (posterolateral complex) in the setting of complex distal femur fracture (AO 33 C3) and exhibited good clinical outcome at 2 years follow up. We describe a successful surgical management and discuss the technical considerations, operative strategies and encountered challenges.