A distractor, because it applies the force directly to the bone, is very powerful and makes distraction easy. The distractor may be used on the side with more comminution. If only an external fixator is available, place one on the medial and one on the lateral side or span the knee joint anteriorly with a unilateral frame.
A bilateral distractor may also be used but may interfere with a later ring implementation.
Note: If a distractor is not available the goal of ligamentotaxis and reduction is still achievable using other techniques such as manual traction.