Bone graft and preliminary fixation
Once the articular surface has been reconstructed, the distraction can be adjusted. It is helpful to have comparative x-rays from the uninjured side. This allows proper length and morphology to be judged.
The remaining defect can then be bone grafted.
While reconstructing the joint surface, check frequently to make sure that no malreduction is occurring.
Using the adjacent joint surface as a template is useful but if the fragment is secured to it with a transarticular K-wire, actual verification of the reduction is more difficult.