Outcomes of Open Reduction and Internal Fixation in Intra-articular Distal Femur Fractures with Incarcerated Patella: A Case Series of a Rare Injury Pattern
Abstract
Abstract Introduction: Distal femur fractures associated with patellar incarceration are rare, complex injuries that pose significant diagnostic and surgical challenges. The patella, an essential component of the knee extensor mechanism, may become entrapped within distal femoral fracture fragments following high-energy trauma, creating a mechanical block to reduction. Failure to recognize this uncommon injury pattern can result in repeated unsuccessful attempts at closed reduction, leading to chondral injury, knee stiffness, and suboptimal functional outcomes. Early diagnosis using computed tomography (CT) imaging and prompt open reduction are crucial to restore articular congruity and extensor mechanism integrity. Due to the rarity of this condition, existing literature is limited primarily to isolated case reports. This study evaluates the functional and radiological outcomes of open reduction and internal fixation in patients with distal femur fractures associated with patellar incarceration. Materials and Methods: This case series was conducted at a tertiary health-care center between February 2024 and January 2026 after institutional ethical approval. Five patients aged 12–35 years with intra-articular distal femur fractures (AO types 33B and 33C) associated with incarcerated patella were included. One patient had a Salter–Harris Type IV physeal injury. Patients with additional ipsilateral limb fractures, prior knee surgery, or severe open fractures (Gustilo–Anderson…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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