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3DCS fixation to the distal fragment

Final plate impaction

Disconnect the T-handle from the screw.

Use the impactor to bring the plate down to the bone with the barrel sliding over the screw shank.

The compression screw may be used to couple the DCS to the plate.

A cancellous screw can then be inserted into the most distal screw hole of the plate to prevent rotation of the main distal fragment around the axis of the DCS.

Pearl: do not use compression screw in osteoporotic patients
Do not use the compression screw in osteoporotic patients – it can cause the DCS thread to strip out from the soft cancellous bone of the medial femoral condyle.