case_images: PMC11823837_01
case_images: PMC11823837_02
case_images: PMC11823837_03
case_images: Clinical picture shows the medial parapatellar approach for distal femur exposure.
case_images: JOCR-15-203-g002.jpg
case_images: PMC11823837_03_JOCR-15-203-g002.jpg
case_images: F2
case_images: Clinical intraoperative photograph shows intra-articular reduction of fractured fragments of the distal femur, held with a bone clamp.
case_images: JOCR-15-203-g003.jpg
case_images: PMC11823837_03_JOCR-15-203-g003.jpg
case_images: F3
case_images: This step is crucial to restoring joint congruity and should be verified with fluoroscopic imaging to ensure accurate reduction, as shown in Fig. 3 and 4.
case_images: Intraoperative X-ray image showing intraarticular fracture reduction with screws, with nail insertion and distal plate attached provisionally with K-wires .
case_images: JOCR-15-203-g004.jpg
case_images: PMC11823837_03_JOCR-15-203-g004.jpg
case_images: F4
case_images: This step is crucial to restoring joint congruity and should be verified with fluoroscopic imaging to ensure accurate reduction, as shown in Fig. 3 and 4.
case_images: Intraoperative X-ray image shows a distal locking screw passed through the distal femur plate and distal hole of the intramedullary nail.
case_images: JOCR-15-203-g005.jpg
case_images: PMC11823837_03_JOCR-15-203-g005.jpg
case_images: F5
case_images: This dual fixation approach enhances stability at the fracture site as shown in Fig. 5.
case_images: Intraoperative X-ray image shows AP X-rays of distal femur, mid femur, and proximal femur showing distal femur nail and retrograde femur fixation.
case_images: JOCR-15-203-g006.jpg
case_images: PMC11823837_03_JOCR-15-203-g006.jpg
case_images: F6
case_images: Maintaining a long working length is necessary by leaving 50% of the plate holes empty, allowing flexibility and stress distribution as depicted in the radiographic template, as shown in Fig. 6.