previous section: 8/9 page: 1/3 next

8Final reduction and fracture compression

Reduction of metaphyseal component

Reduction of metaphyseal component

The key concept in reduction of the metaphyseal component of the fracture, when using a blade plate, is that correct insertion of the blade into the distal femur allows the surgeon to use the plate to achieve the metaphyseal fracture reduction. When brought down to the femoral shaft the correct frontal plane alignment has been assured. The surgeon must then control for length and rotation. Length can be aided by manual traction. The sagittal plane deformity correction is determined by rotational control, using the slotted hammer, during seating chisel insertion. Small corrections of extension/flexion deformity can be achieved by moving the proximal end of the plate forwards or backwards on the lateral femoral cortex, but there is little room for maneuver.

Take care to restore the mechanical axis in all planes of the femur. Give consideration to fracture reduction in:

  • Varus/valgus
  • Flexion/extension
  • Internal/external rotation
  • Translation
  • Lengthening/shortening

Secure the plate to the proximal femur with a Verbrugge clamp.