Scoping within a few days with low gravity flow or pressure and using the shaver in front of the scope to suck out the clots to see in front of scope is all always possible. Do not raise flow or pressure as it will break up th clots and compromise vision further due to bernoullis effect .scoping 3 days post injury in low velocity fall like above in 89 year old is possible.
Using cement below the graft adds to support and walking.went PWB with a valgus unloader brace is possible for immediate mobilisation with only screws to avoid major plates etc in patients with anticogulants etc. .
Scope and using the acl jig allows to centralise the guide wire precisely at the depressed area and visualise elevation better than xrays specially mild tilts. A coring reamer over the guide wire within half cm below the depressed fragment gets you a graft which u can insert under the depressed fragment after elavatio and seal it below with bone cement or substiute
Reversed images due to introp imaging issues
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