Proximal guide-wire insertion
If the length and rotation of the fracture fragments are correct, insert the
proximal guide wire after verification that the LISS plate lies on the
midlateral aspect of the femur.
It is extremely important to establish correct placement of the guide wire in
order 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 LISS plate on the midlateral aspect
of the femur has been established, a proximal guide wire is inserted through
the stabilization bolt. 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.
Pearl: monocortical proximal guide-wire insertion
Insert the proximal guide-wire through one cortex only. This reduces the
risk of guide-wire breakage
Once the reduction has been successfully completed and the LISS plate has
been positioned correctly, the locking-head screws can be inserted.