en Clinical Medicine Clinical Medicine گزارش موردی Case Report Article <span style="font-size:12pt"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif">Open distal femur fractures are uncommon but challenging injuries often resulting from high-energy trauma and associated with high complication rates including infection and nonunion (1,12). We present a 20-year-old male with an open comminuted (AO/OTA type 33-C3) distal femur fracture and extensive soft tissue injury including lateral collateral ligament and patellar tendon rupture. The patient was treated with a two-stage approach: initial irrigation, debridement, and external fixation followed by definitive open reduction and internal fixation (ORIF) with locking plate, autologous bone grafting, and polypropylene mesh augmentation, along with ligamentous repair. At 8 weeks, the patient achieved a stable knee and improved range of motion without complications. This case highlights that mesh augmentation can be a useful adjunct in managing bone loss in high-energy distal femur fractures (5,14&ndash;16) and emphasizes the importance of early soft tissue repair in restoring knee function (2,9)</span></span></span></span><br> &nbsp; Femoral Fractures,Intertrochanteric,Bilateral ,Infant 21 21 http://journal.zums.ac.ir/browse.php?a_code=A-10-7409-2&slc_lang=en&sid=1 Aboalfazl nouri Abno628188@gmail.com 5200319475328460089006 5200319475328460089006 Yes Department of Zanjan orthopedic Surgery Siamak Shabani dr.siamakshabani@gmail.com 5200319475328460089007 5200319475328460089007 No Department of Zanjan orthopedic Surgery Seyede rahele arkian rahele.arkian75@gmail.com 5200319475328460089008 5200319475328460089008 No Department of Zanjan orthopedic Surgery