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Patellar dislocation and lateral femoral condyle fractures occur in young patients with specific injury mechanismsRare femur fractures can occur during a patellar dislocation

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Key Takeaway
Note that patellar dislocation and lateral femoral condyle fractures often involve the weight bearing area.

This case report and literature review examines the clinical presentation and management of a rare injury involving patellar dislocation and OTA 33-B1 intra-articular fractures of the distal femur. The review focuses on 7 patients, with a mean age of 19 years, to provide clinical perspectives on diagnosis and treatment planning for these specific fractures.

The authors note that most fractures in this series involved the weight bearing area of the lateral femoral condyle. The mechanism of injury is likely attributed to direct impaction of the patella combined with shear stress from the tibial plateau.

A primary limitation of this evidence is the small sample size of 7 patients. Because this is a case report and literature review, the findings are not intended to establish definitive clinical protocols but rather to provide information on a rare fracture type. Clinical application should be approached with caution due to the limited scope of the data.

When your kneecap slips out of place, it is usually a painful but common injury. However, in some cases, the force of the dislocation can cause a serious break in the femur, the large bone in your thigh. This specific type of fracture happens in the weight-bearing area of the bone, which makes it a complex issue for doctors to manage.

Researchers looked at a small group of patients, mostly young adults with an average age of 19, who suffered these rare fractures. They found that the injury likely happens because the kneecap hits the bone with great force while the lower part of the leg puts extra stress on the joint.

Because these fractures are rare, this information helps doctors better identify the injury and plan the right surgery or treatment. While the study only looked at seven patients, it provides a clearer picture of how these specific bone breaks happen and what to expect during recovery.

What this means for you:
A rare but serious femur fracture can occur during a kneecap dislocation, especially in young patients.

Common questions

What kind of injury was studied?

The study looked at patients who experienced a patellar dislocation, which is when the kneecap slips out of place. In these specific cases, the patients also had a fracture of the distal femur, which is the lower part of the thigh bone.

Who was affected by this specific injury?

The study focused on a small group of patients who suffered these rare fractures. The average age of the patients in this group was 19 years old.

Why is this fracture hard to treat?

The fractures were found in the weight-bearing area of the lateral femoral condyle. Because these injuries are rare, this information helps doctors better understand the injury to plan the correct treatment and surgery.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundConcomitant patellar dislocation with OTA 33-B1 intra-articular fracture of the distal femur involving both weightbearing and non-weightbearing lateral femoral condyle fracture is a rare entity, with few case reports in the literature, and no standard approach to its treatment. In this study we review previous cases along with describing one patient presenting to our institution.MethodsA systematic literature search in PubMed/MEDLINE and Web of Science was conducted using the key words “patella dislocation,” "medial patellofemoral ligament injury”, “OTA 33-B1 lateral femoral condyle fracture” to retrieve related articles. Data extracted included patients’ demographics (age, sex),injury mechanism, type of dislocation, location of fracture, treatment modality, and outcome. In addition, a detailed description of the course of this patient's disease is presented and discussed.ResultsThis study included 7 patients including reported literature in previous publications as well as one primary case from our own institute. The mean age of the patients was 19 years, with most fractures involving the weight bearing area of the lateral femoral condyle(OTA 33-B1).Based on the symptoms compared, injury mechanism, management modality and outcome. This study provides more information on this rare type of fractures from a clinical point of view which may be useful in diagnosis as well as treatment planning and further research studies.ConclusionsInjuries to the lateral femoral condyle(OTA 33-B1 intra-articular fracture of the distal femur), involving both weightbearing and non-weightbearing portions are extremely uncommon sequelae of a patellar dislocation. The mechanism of injury is probably due to direct impaction of the patella with additional shear stress imparted by the tibial plateau. Resulting in comminuted fragmentation of the bones in these articulations.
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