Distal femur Partial articular fracture, lateral condyle, sagittal fragmentary

Open reduction internal fixation (ORIF); cannulated lag screws

ORIF - cannulated lag screws

Indication summary: Large fragment, good bone quality, low demand patient

Skill: Highly experienced and skilled surgeon
Equipment: Full specialized surgical and imaging resources

Displaced fractures should be fixed with lag screws, which may be cannulated. Small intermediate fragments may be fixed with bioresorbable pins, so that anatomical restoration of the articular surface can be achieved and early active mobilization of the joint surface can be undertaken.

In poor bone stock, or more vertical fracture planes a buttress plate is added to enhance stability.

Indication

  • All lateral sagittal split fractures

Contraindication

  • Patient not medically fit for surgery

Advantages

  • Direct articular surface reduction
  • Early mobilization of the knee joint
  • Lower incidence of osteoarthritis

Disadvantages

  • Risk of failure of bioresorbable pin
  • Risk of knee joint stiffness

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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v1.0 2008-12-03