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The fragment is visualized directly.

The fragment is triangular. It may be held with a K-wire as a joystick and brought down into its anatomic position. Simple finger pressure may be adequate to maintain reduction while the K-wire is driven into the tibia.


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Alternatively, it may be possible to hold the reduction with a large pointed bone forceps.


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As it is reduced the apex of the triangle can be seen to fit into the cortical defect. This confirms anatomic reduction even though the joint surface cannot be directly visualized.

Reduction may also be confirmed with image intensifier.


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Provisional fixation of the Volkmann’s triangle is achieved with two K-wires, or 1.25 mm guide wires for the cannulated screws. The guide wires should be perpendicular to the fracture plane, at the desired positions of the planned screws, and should not penetrate the anterior cortex.

Check reduction and position of guide wires under image intensification.