DePuy Synthes
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4
Reduce the fracture
In an intra-articular fracture, first reconstruct and stabilize the
entire joint. The figure shows the possible positioning sites
for lag screws in the condyles (in red).
Take care to ensure that these lag screws will not collide with
the screws inserted through the insertion guide.
The fracture can be aligned manually by traction using a
temporary knee-bridging external fixator or a distractor. In-
traoperative x-ray or image-intensifier control is recommen-
ded to check the reduction.
The anteromedial insertion of a Schanz screw can be benefi-
cial in distal fragment manipulation.
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Surgical approaches
Extra-articular fractures
Perform a skin incision from Gerdy’s tubercle about 80 mm in
a proximal direction. Split the iliotibial tract in the direction of
the fibres. Open the space between the lateral vastus and
the periost. Distally, the lateral vastus muscle inserts mainly
on the femoral ridge. There are no muscle insertions on the
lateral periost or bone. The plate can be inserted into the
space between the periost and the muscle.
Intra-articular fractures
In intra-articular fractures, an anterolateral arthrotomy provi-
ding good control of the reduction is recommended. This
arthrotomy also allows a subsequent insertion of the plate
and can be used to insert lag screws from medially.
Possible positioning sites for lag screws (in red)
