A New Pattern of Distal Femoral Unicondylar Fracture in a Middle-Aged Man

Background: Distal femoral fractures are not common among all fractures and the incidence rises with age. While this kind of fracture is usually caused by low-energy trauma in the elderly, there are many known fracture patterns. We encountered a new pattern of fracture in a middle-aged man. Case Presentation: A 56-year-old obese man presented to our hospital with direct trauma from a motor car accident. We encountered a bizarre pattern of distal femoral fracture, which was a biplanar unicondylar fracture in medial condyle of the femur through physeal remnant. This fracture was similar to the pattern of Salter-Harris type III fracture and unicondylar type of T-type simple articular epiphyseal fracture in Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification (type 43.C1.3). The fracture was fixed with two 7.3mm cannulated screws. Conclusions: A direct trauma to the distal femur can result in different fracture patterns. In our case, a fracture through physeal remnant of distal femur has been occurred in a morbidly obese patient with radiographic signs of osteoarthritis (OA). We hypothesize that the conduction of axial and anterior to posterior forces through the weak epiphyseal line in a patient can cause a new pattern of fracture similar to AO/OTA type 43.C1.3.