Anterior-posterior lag screw
Through a separate stab incision, taking care not to injure the tendons or neurovascular structures, the chosen 4.0 mm cancellous bone screw is inserted from anterior to posterior. It should come to rest with its threads completely beyond the fracture line. The use of a washer is recommended, especially in osteoporotic bone.
If the threads of the cancellous bone screw come to lie on both sides of the fracture line, it may be replaced by a cortex lag screw, finding purchase in the posterior tibial cortex.