Surgical Discussion

Patient positioning:  The patient was positioned laterally to optimize access to the lateral distal femur and facilitate the surgical approach.

Anatomical surgical approach:  The surgical approach was centered over the lateral epicondyle. The posterior border of the iliotibial band and biceps femoris were identified. The common peroneal nerve was mobilized and protected. The lateral collateral ligament (LCL) was clearly defined. A posterior capsulotomy was performed between the biceps femoris and LCL, as well as an anterior capsulotomy to the LCL. A lateral epicondylar osteotomy was executed, reflecting the posterolateral corner structures distally to expose the fracture site.

The surgeon noted that the lateral epicondylar osteotomy provided excellent exposure to the posterior aspects of the lateral distal femur, allowing for direct reduction of the fracture fragments. Implants were placed behind the biceps femoris. The capsule and osteotomy were repaired following reduction and fixation.

Postoperative protocol:   Postoperative rehabilitation included early range of motion exercises with weight-bearing as tolerated, progressing to full weight-bearing by 6 weeks post-surgery.

Follow up:   Not specified

Orthopaedic implants used:   Orthopaedic implants used included screws and plates for fracture fixation and osteotomy stabilization.