Challenges in ipsilateral intertrochanteric and distal femur shaft fracture with patellar tendon avulsion

A middle-aged man presented with a history of high-energy trauma with no open wounds, sustaining ipsilateral intertrochanteric and distal femur fractures with a patellar lower pole avulsion fracture. The patient underwent short proximal femoral nailing for intertrochanteric fracture, open reduction and internal fixation with plating for distal femur fracture and patellar tendon repair through transosseous tunnels in the patella. A precise clinical and radiological diagnosis followed by early management by internal osteosynthesis and early and adapted functional rehabilitation made it possible to obtain good long-term results. In case of a high-velocity trauma with complex fracture patterns, it is important to plan the timing of surgery, fixation of each fracture and the order of fixation of fractures to reduce intraoperative time and produce better postoperative results.