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4DCS fixation to the distal fragment

Inserting the DCS.

DCS insertion

After tapping, insert the DCS over the guide wire, so that its outer end is still visible 2-3 mm outside the lateral cortex of the distal femur.

In order for the plate barrel to slide over the screw, the T-handle should be parallel, on the lateral view, to the long axis of the distal fragment.

Pearl: omit tapping in osteoporotic bone
In osteoporotic bone, tapping should be omitted.