Restoration of anatomical alignment while preserving the soft-tissue envelope around the fracture site remains a challenge during distal femur fracture fixation. Although the lateral distal femoral locking plate allows surgeons to achieve adequate bony stability, their application has been associated with malalignment leading to inferior outcomes. We propose a biologically friendly, percutaneous technique that sequentially reduces and aligns distal femur fractures with an anterior external fixator before definitive fixation with a lateral distal femoral locking plate.

Reduction plating is a concept used to provisionally maintain reduction in the treatment of various fractures throughout the body. It is often used in challenging fracture patterns where the use of reduction clamps hinders placement of the definitive fixation construct. In this article, we present a technique for fixation of ankle fractures, in which a mini-fragment plate is used to keep provision reduction of the fracture, while the definitive plate is applied. This technique is particularly useful when using a posterolateral one-third tubular plate as your definitive construct. This study provides Level V evidence.