Use of distractors and/or external fixators
In order to reduce these complex fractures one may need to use two femoral distractors one on the medial and one on the lateral side. To do this place the knee in slight flexion.
One can also achieve the same with the use of two external fixators or one distractor and one external fixator. The use of the external fixators makes intraoperative adjustments almost impossible because they do not allow for rotational or angular correction.