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4Reduction and fixation of the articular block

Reduction of the articular block

The chosen approach must adequately expose the articular surface of the distal femoral condyle. Reduction aids which are helpful include:

  • A 5.0 mm or 6.0 mm Schanz pin in the medial and/or lateral femoral condyle to act as a joystick.
  • Pointed reduction forceps, or large pelvic reduction clamps, to clamp from medial to lateral across the intercondylar split.
  • Modified pointed reduction forceps on the medial or lateral aspect of the femoral condyles to help reduce frontal plane fractures (Hoffa fractures). The pointed reduction forceps are modified by straightening the curved tips. The straightened tips can then be placed in small 2.0/2.5 mm drill holes in the bone.

Pearl: combination of reduction aids
Attempts at reduction of the intercondylar split with the pointed reduction forceps alone are often unsuccessful, as rotational control of the femoral condyle is also needed. The use of the Schanz pin in conjunction with the pointed reduction forceps is therefore preferred.