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7Preliminary LISS plate fixation

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.