Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 4 3 2020 05 07 65 68 Seyyed Hadi Kalantar Assistant Professor,Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Soroush Baghdadi Assistant Professor,Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Javad Dehghani Firoozabadi Assistant Professor,Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Sareh Moslemi Assistant Professor,Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Saeed Panahi Radiologist, Department of Radiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2019 11 18 2020 01 14 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 the 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 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 the distal femur has 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.   https://jost.tums.ac.ir/index.php/jost/article/view/129 https://jost.tums.ac.ir/index.php/jost/article/download/129/129