Open reduction and internal fixation

Intra-articular fractures involving the lower femur and the tibial plateau are important fractures involving the weight bearing area of the largest joint. Joint alignment and congruity have to be restored back to normal to achieve good results. A degree of direct articular cartilage damage occurs at the time of injury and is confirmed by MRI scans. This precludes universal good results but the effort should go in to achieve alignment and congruity. The use of bone graft or substitutes may be required to fill up gaps in the metaphyseal area. Minimally invasive techniques like hybrid fixators help in biological fixation. Following the correct technique CPM is used to achieve complete range of motion. Weight bearing is restricted until bony consolidation occurs.