Additional screw placement
Insert additional screws proximally and distally for a total of 4-5 screws in the distal fragment and 4-5 screws in the proximal main fragment.
In oblique, single-plane fractures, an interfragmentary lag screw may be inserted through the plate.
Final check of fracture reduction and fixation
Gently move the knee through a full range of motion. Carry out a clinical assessment of the rotational profile. Finally, perform a radiographic assessment of the frontal-plane alignment (varus/valgus) and sagittal-plane alignment (extension/flexion).
Examine the knee for any ligamentous instability.
Irrigate all wounds copiously. Close the iliotibial tract using absorbable sutures. The use of suction drains may be considered. Close the skin and subcutaneous tissue in the routine manner.