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6Preliminary plate fixation

Screw length measurement in distal fracture fragment

Screw length measurement in distal fracture fragment

Once you have confirmed that the proximal end of the plate is appropriately aligned on the femur and the distal end of the plate is appropriately placed, insert the distal screws. Use the measuring device indirectly to determine the appropriate screw length from the previously inserted guide wires.

Although screws may be inserted in any order, it is usual to start with the central 7.3 mm screw. Advance the guide wire until it reaches the medial cortex of the femoral condyle. Determine the appropriate screw length using the measuring device. For proper screw length measurement, the measuring device must contact the end of the threaded wire guide. This will place the tip of the screw at the tip of the guide wire.


Pearl: self-drilling/self-tapping screws

The self-drilling, self-tapping flutes of the 7.3 mm and 5.0 mm screws make predrilling and pretapping unnecessary in most cases. In dense bone, the lateral cortex can be predrilled, if necessary:

  • use the 5.0 mm drill bit for 7.3 mm screws
  • use the 4.3 mm drill bit for 5.0 mm screws.