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. 2018 Jul 25;43(5):1193–1204. doi: 10.1007/s00264-018-4061-1

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© The Author(s) 2018

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Fig. 5 — Type 33.A2 distal femoral fracture of a 92-year-old lady following a fall at her garden (a and b represent pre-operative anteroposterior and lateral views of the right distal femur). Of note, an ipsilateral cemented Thompson’s hemiarthroplasty. Randomised and treated with a LISS plating system inserted with a mini invasive technique, spanning proximally the stem of the hemiarthroplasty to neutralise an in-between implants stress riser (d, e, f). The fracture was noted to be fixed and was malunited in 15° of the valgus (c and d). The same patient underwent further surgery 9 months later whereas two of the metaphyseal locking screws were removed as they were found to be irritating the soft tissues over the medial femoral condyle (c)