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8Preliminary LCP or LISS fixation

Distal femoral shaft fracture – Minimally invasive LISS bridge plate – Proximal guide wire

Proximal guide wire insertion

If the length and rotation of the fracture fragments are correct, the proximal guide wire can be inserted after it has been verified that the fixator is on the midlateral aspect of the femur.

It is extremely important to establish correct placement of the guide wire, to ensure proper proximal insertion of the monocortical locking-head screws. After the proper length and rotation are assured, and appropriate positioning of the proximal portion of the plate on the midlateral aspect of the femur has been established, a proximal guide wire is inserted through the sleeve. It is still possible at this point to correct the sagittal plane alignment, as noted below. Small corrections of the adduction of the proximal fragment or of the varus/valgus alignment of the distal femoral condyle are possible.

Once the reduction has been successfully completed and the LCP or LISS plate has been positioned correctly, the locking-head screws can be inserted.