Use of Traction Table for Reducing Complex Distal Femur Fractures: A Technical Trick.

Complex intra-articular distal femur fractures (AO 3.3.C) present many challenges, especially with regard to patient preparation and approach. Traditionally, patients lie supine with a bolster or triangular wedge placed below the knee to allow knee flexion. This corrects the hyperextension deformity of the distal femoral fragment caused by the gastrocsoleus complex. Although well established, the minimally invasive plate osteosynthesis (MIPO) technique presents with limitations, especially with regard to patient preparation and approach. In this case report, we describe a lateral approach to the MIPO technique using the Eschmann traction table with the tibia nailing attachment and femoral condyle pads to achieve and maintain satisfactory fracture reduction throughout the procedure. Importantly, this also allows less dependency on surgical assistance. To our knowledge, this is the first case report describing a lateral approach to the MIPO technique using the Eschmann traction table for the reduction of complex distal femur fractures.