Article Details

Background: Knee dislocation (KD) is uncommon but limb threatening due to popliteal artery injury. Concomitant ipsilateral femoral shaft fracture with KD is rare and diagnostically challenging, especially when dislocation has spontaneously reduced.
Case: A 28-year-old man sustained a high energy motorcycle collision. Initial assessment revealed a displaced femoral shaft fracture and an intact dorsalis pedis and posterior tibial pulse. CT pan scan with lower limb CTA demonstrated a displaced distal diaphyseal femoral fracture, a congruent knee joint, and a non-opacified distal popliteal segment with poor tibial runoff. Within two hours the foot became pulseless; the knee was grossly unstable in all planes, consistent with a spontaneously reduced KD. Despite urgent transfer for revascularisation and external fixation, intra operative assessment confirmed established ischaemic myonecrosis and a primary above knee amputation was performed.
Conclusion: The case underscores how an unstable femoral shaft fracture can distract from ipsilateral KD and evolving popliteal injury, and reinforces the need for protocolised serial neurovascular examinations and expedited revascularisation.

Keywords: Knee dislocation; Popliteal artery injury; Femoral shaft fracture; Spontaneous reduction; Amputation