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5Fixation

Screw fixation

Screw fixation

With the K-wires placed appropriately and with image intensification verifying accurate reduction, cannulated screws can be placed over the K-wires.
Medially, where comminution is common, one should avoid lag effect and the screw is placed without compression (position screw). The screw head on the medial side is often countersunk through the medial edge of the talonavicular articular surface.
The lateral side, with no bone loss and interdigitation of the bone, which can withstand compression, is best treated with a cannulated lag screw. The screw on the lateral side is not inserted through articular cartilage but through bone on the lateral side of the talar neck.