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4Preliminary reduction

Use of distractors and external fixators

Distractors, because they apply the force directly to the bone, are very powerful and make distraction easy. Use the distractor on the side with more comminution. Usually, the medial side can be managed with an external fixator because it is usually less comminuted. If only external fixators are available, place one on the medial and one on the lateral side or span the knee joint anteriorly with a unilateral frame.