Surgical Discussion

Patient positioning:  Supine position on a radiolucent table, with the affected limb prepared for lateral access.

Anatomical surgical approach:  A lateral parapatellar approach was utilized, involving an incision along the lateral aspect of the distal femur. The vastus lateralis muscle was elevated subperiosteally to expose the fracture site. Careful dissection allowed for direct visualization and reduction of the articular surface.

The surgeon emphasized the importance of achieving anatomic reduction and stable fixation to allow for early weight-bearing. The fixation strategy included interfragmentary compression and the application of a large antiglide plate to ensure stability. The surgeon expressed confidence in the construct's ability to withstand early mobilization, challenging traditional postoperative weight-bearing restrictions for articular fractures.

Postoperative protocol:   Immediate full weight-bearing as tolerated, with emphasis on early mobilization to promote cartilage healing in the absence of shear forces.

Follow up:   Not specified.

Orthopaedic implants used:   Large antiglide plate, interfragmentary compression screws.