Reduction of metaphyseal component
The key concept in reduction of the metaphyseal component of the fracture
when using a Condylar LCP is that proper application of the Condylar LCP on the
distal femur allows the surgeon to use the plate to achieve the metaphyseal
fracture reduction. When brought down to the proximal femoral shaft, the
correct frontal plane alignment has been assured. The surgeon must then control
length, rotation, and sagittal plane deformity (hyperextension/hyperflexion).
When performed in an open manner, length can be aided by manual traction. The
sagittal plane deformity correction can be aided by supracondylar bolsters.
Open reduction is aided by:
- Bolsters posterior to the supracondylar region, which help correct the
hyperextension deformity of the distal femoral articular block.
- Manual traction which helps restore length of the limb.
- Direct pointed reduction forceps placement (particularly helpful in spiral
fractures of the metaphysis).
- A Hohmann retractor, which may be used as a lever to correct translational
- The plate itself; by applying the plate in the correct position on the
distal femur, appropriate alignment is established when the plate is fixed to
the proximal femur.