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.
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
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.