Author(s): Mamadou Moustapaha Diallo, Alpha Mamadou Felah Diallo, Alhassane Barry, Sory Sidimé, Mamadou Madiou Diallo and Léopold Lamah

Abstract: Fracture of the medial femoral condyle is a rare pathology. We report a case of firearm attack on the medial femoral condyle treated by screwing.Presentation of the case: 41-year-old man with no history of intoxication following an attack at his home that we received for open trauma to the right knee.He presented with a puncture wound on the posteromedial aspect of the thigh with severe pain in the right knee and functional impotence. The pedal and posterior tibial pulses were well perceived. The radiographs revealed an articular fracture of the internal femoral condyle with an oblique line with inclusion of the ball-type foreign body lodged in the external part of the left knee Fig 1 (Classified 33-B2 according to AO). Two days later, we carried out a debridement of the wound, an open reduction and a double screwing then extraction of the ball. The patient was seen again three weeks postoperatively with good healing of the surgical wound. There was skin disunity near the point of entry of the bullet, no purulent discharge which improved. At the final evaluation, the patient had mobility of 0° to 120° and could walk without pain with monopodal support.Discussion: Fracture of the internal femoral condyle is rare, as with any joint injury, an anatomical reduction of the articular surface must be obtained, then solid fixation is necessary. In fractures with an oblique line, a supporting plate is necessary to counter vertical shear forces.However, there are no anatomical plates available in our department that fit the medial femoral condyle. We used two cancellous screws. The assembly was solid with joint stability. Postoperative radiographs confirmed anatomic reduction and the patient achieved a good result.Conclusion: Cancellous screws are an acceptable solution for internal femoral condyle fracture.

DOI: 10.22271/27078345.2024.v6.i1a.184

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