1. Large reduction clamps around the medial and lateral condyles to reduce them together, then fix with k-wires.
2. Now fix the articular fracture with lateral to medial screws. Make sure you are distal enough. If you use cannulated screws it’s easier. Make sure to place the screws one anterior and one posterior to your nail. Leave the K wires for the cannulated screws in place, in case you need to change them later.
3. Nail the fracture as per usual
4. Lock the nail per usual, can place another 4-6 screws in the distal femur depending on the nail used.
