Combined direct and indirect reduction of comminuted four-part

---

intraarticular T-type fractures of the distal femur. Johnson-EE Division of Orthopaedic Surgery, Center for Health Sciences, University of California, Los Angeles 90024. Clin-Orthop. 1988 Jun(231): 154-62 Five patients with identical severely comminuted four-part intraarticular T-type fractures of the distal femur were treated with a combination of direct reduction of the condylar anatomy and indirect reduction of the metaphyseal fragments using a 95 degree blade plate and femoral distractor. In all patients there was a coronal-axial fracture of the medial condyle anterior to the origin of the posterior cruciate ligament (PCL) associated with disruption of the patellofemoral articulation (four-part fracture). There were no associated intraarticular or extraarticular knee ligament injuries with this specific fracture pattern. Following fracture stabilization all knees were stable. Anatomic reduction of the articular surface and restoration of alignment were obtained in every case. Functional results were rated as good to excellent in all patients.