Additional locking-head screws (LHS) are subsequently inserted both proximally and distally. In general, a total of five proximal and five distal LHS are placed for the LISS or 4 bicortical screws with the LCP. In case of severe osteoporosis, six proximal and six distal LHS can be used. Bicortical self-tapping LHS are recommended for shaft fixation in severe osteoporosis.
In simple fracture types, 2-3 plate holes should be left unused over the fracture zone to avoid high stress concentration of the implant.