Hypothesis 1

Trauma-  Initial trauma most likely would have resulted from the fall off the bed.  The fall could have displaced the patella, thus stretching and weakening the ligaments that hold it in place.  Thus the joint could have become hyperflexible and prone to more significant injuries (ie cruciate ligament tear) because normal support and stability of the joint is decreased.  During the initial injury (ie hairline fracture) a spontaneous self-healing process could have resulted in misalignment of ligaments and joints.  This is supported by the fact that it took the initial injury one month to heal.  Once again the joint would be more susceptible to everyday activities resulting in a more serious injury.        

We feel that there is only bone damage, more specifically the femur fracture.  When the femur repaired itself without any intervention, it resulted in a lateral bowing of the femur.  This would then cause the medial patellar luxation.