Definitive articular surface fixation
Definitive lag screws may then be inserted in the distal femoral articular
block in several directions:
- Screws may be inserted along the periphery of the articular surface of the
lateral femoral condyle going from lateral to medial to fix the intercondylar
- Screws may be inserted starting just proximal to the articular surface and
aimed from anterior to posterior to fix the frontal plane fracture (Hoffa
- In severe fractures, a diagonally inserted screw may be placed.
These screws may be fully threaded 3.5 mm lag screws (shown with gliding
hole), 6.5mm partially threaded lag screws, or 4.0/4.5 mm cannulated partially
threaded lag screws.
Insertion of screws in this manner allows a „free zone“ of bone into which a
laterally based plate system can be placed (dotted circle).