The lateral parapatellar approach provides a good view of the articular surface of the distal femur. With a longitudinal division of the quadriceps tendon and extensor mechanism, the patella can be dislocated medially.
The arthroscopic approach is only recommended in minimally, or nondisplaced, fractures in young patients. Advanced experience in arthroscopic surgery is essential.
Make a longitudinal, slightly oblique medial parapatellar incision along a line starting 5 cm above the superior pole of the patella to the tibial tubercle.
Inserting percutaneous instrumentation through safe zones reduces the risk of damage to neurovascular structures.