[Distal femoral fractures. Transarticular reconstruction, percutaneous plate osteosynthesis and retrograde nailing].

Techniques for operative treatment of supra- and intercondylar fractures have changed in recent years. Some of these changes have come about in reduction techniques and implant selection. Operative approach concepts, which had remained unchanged for several decades, have been critically evaluated and modified, leading to a minimally invasive osteosynthesis (MIO) with transarticular joint reconstruction, closed plate positioning techniques or retrograde intramedullary nailing. These techniques result in better operative visualization and management of intraarticular comminution, safer fracture healing and better functional outcome. New strategies and techniques for the avoidance of axial malalignment, rotational deformities and leg length discrepancies are described.