[Ortho] Дистальное бедро и клинковая пластина

[Ashish Jaiman]

Dear Alex,
I feel that there are a few problems in this case like
1. inadequate( not so rigid fixation )
2. possibility of subclinical infection (because of decreased knee ROM - REF: CAHRNLEYS BOOK ON CLOSED # TT )
3. non anatomical reduction

So, in my opinion; first get a CRP quantitative estimation- if it
comes elevated than go for serial estimation within a week, if it
comes within normal limits than go for surgery directly.  
In both cases arrange for intra op gram staining and send tissue for
culture and sensitivity. 
Removal of implant, Re-reduction, bone grafting (match- stick shaped
bone grafts- as  they resist infection in a better way), and fixation
with polyaxial distal femur locking plate (as one will not be able to
get secure purchase if new screw passes through blade plate site)
one can also think of instilling antibiotic in wound before wound
closure (ref campbell- antibiotics with autogenous bone graft)
What is your plan?
Dr. Ashish Jaiman