Surgical Discussion

Patient positioning:  Supine positioning was utilized, with the affected limb draped freely to allow for intraoperative manipulation and access from both medial and lateral sides.

Anatomical surgical approach:  A medial subvastus approach was performed, involving the elevation of the vastus medialis muscle to expose the distal femur. This was followed by a lateral approach to facilitate comprehensive access to the fracture site for reduction and fixation.

The surgeon noted that the fracture's low position precluded the use of standard lateral-only fixation techniques. Medial and lateral approaches were necessary to achieve stable fixation. Following the initial fixation of the distal femur, a subsequent procedure was performed to address the PCL avulsion using a tension plate technique.

Postoperative protocol:   Postoperative rehabilitation included initial non-weight bearing with gradual progression to weight-bearing as tolerated, focusing on range of motion exercises and strengthening to support knee stability.

Follow up:   Not specified

Orthopaedic implants used:   Orthopaedic implants used included a tension plate for PCL avulsion repair and fixation devices for the distal femur fracture (specific implants not detailed).