ORIF - cannulated lag screws
Indication summary: Large fragment, good bone quality, low demand patient
If the fracture is displaced, open reduction internal fixation (ORIF) techniques are necessary.
Beyond 24-48 hours after injury, the fracture hematoma begins to organize. After 48 hours it may well be easier to perform an open approach as it may be impossible to maintain an anatomical reduction by closed means.
Displaced fractures should be fixed with lag screws, which may be cannulated. In poor bone stock, or more vertical fracture planes a buttress plate is added to enhance stability.
- All lateral sagittal split fractures
- Patient not medically fit for surgery
- Direct articular surface reduction
- Early mobilization of the knee joint
- Lower incidence of osteoarthritis
- Risk of knee joint stiffness
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|