MIO - lag screws
Indication summary: Large fragment, good bone quality, low demand patient
If the fracture is completely undisplaced, or minimally displaced, closed reduction internal fixation techniques are often appropriate through minimal incisions. Displaced fractures are often difficult to reduce, due to interposed soft tissue, or organizing fracture hematoma. It is easier to perform closed reduction internal fixation techniques within the first 24-48 hours after injury, before the fracture hematoma begins to organize.
Displaced fractures should be fixed with lag screws. Unfixable, small fracture fragments may need to be excised or washed out of the knee joint.
In minimally displaced fractures reduction may be checked arthroscopically. Standard lag screws are inserted under image intensifier guidance.
- Minimally displaced medial sagittal split fractures
- Patient not medically fit for surgery
- Displaced fractures
- Lack of arthroscopic experience
- Indirect articular surface reduction
- Minimally invasive approach
- Early mobilization of the knee joint
- Lower risk of secondary osteoarthritis
- Imperfect reduction
- Technically demanding
|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|