Surgical Discussion

Patient positioning:  Supine position with the affected limb prepared for percutaneous intervention and external fixation.

Anatomical surgical approach:  Percutaneous approach was utilized for the reduction of the diaphyseal component, employing small stab incisions in line with planned definitive surgical approaches. Percutaneous clamping was used to achieve reduction, followed by insertion of 3.5mm lag screws to stabilize the diaphyseal extension.

The surgeon emphasized the importance of achieving accurate reduction of the diaphyseal component to prevent magnified mal-reduction at the joint level. The early stabilization with lag screws and external fixation was performed to accelerate soft tissue recovery and simplify the definitive operation. The definitive fixation involved open reduction of articular components and fragment-specific fixation once swelling allowed, approximately one week post-initial intervention.

Postoperative protocol:   Postoperative rehabilitation included initial immobilization with the external fixator, followed by progressive weight-bearing as tolerated after definitive fixation. Early range of motion exercises were encouraged once stability was confirmed.

Follow up:   Not specified.

Orthopaedic implants used:   3.5mm lag screws, knee-spanning external fixator.