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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Treatment is dependent on the type of fracture. In general:

large displaced fragments should be perfectly reduced and fixed in position - usually by open operation
large depressed fragments may be elevated back into position by pushing upwards from below, with the residual osteoarticular cavity packed with a cancellous bone graft - either from the femoral condyles or the iliac crest
comminuted fractures with slight depression in the plateau, comminuted fractures in elderly or unfit patients, and complex fractures, are usually managed conservatively - the fracture is reduced closed, and after the joint has been aspirated, held by skeletal traction. The patient is mobilised early - either with active exercises or initially, through a Continuous Passive Motion - CPM - machine

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