If there is inadequate bone stock for plate stabilization, medially based structural allograft will provide additional support.
The approach used for plate fixation is developed anteromedially to allow for the strut application. Care is taken minimize biological insult.
3. Application of strut allograft
Strut allograft should be obtained from the bone bank and fashioned to fit the exposed femur. Assure the allograft is of appropriate length to get adequate fixation on each fracture fragment (at least 2 cerclage wires per fracture side).
Apply strut allograft to either the lateral, medial, or anterior aspect of the femur. Secure with 2 cerclage wires on each fracture fragment. Distance between the cerclage wires should be at least 2 cm.