Reasonable attempts should be made to repair the articular surface, but there may be small osteochondral defects that are not reconstructable.
Larger fragments require ORIF with small screws or sutures.
Specialist techniques to reconstruct the articular surface are available and include osteochondral autograft and allograft transfer.
Fixation can be achieved using a small fragment screw system (A or B), absorbable pins (C), or sutures. In general, screws provide better compression of the fracture but require an osteochondral fragment that is sufficiently large to accommodate the screw head.
Irrespective of implant, technique should include measures to ensure that the screw head is not prominent.