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3Screw fixation

Alternative: lag screw insertion

An alternative technique is lag screw fixation.

The screw enters the styloid process through the peroneus brevis tendon insertion and is angled obliquely medially and distally. It gains purchase in the strong medial cortex distal to the fracture.

The proximal fragment is overdrilled as a gliding hole to allow interfragmentary compression. Screw size should be selected according to the size of the bone. 3.5 or 4.0 mm is usually sufficient.