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Long oblique head fracture of the proximal phalanx – Lag screw fixation

Drilling for lag screws

There are two options to prepare the gliding hole and the threaded hole:

1) Gliding hole first
Drill the gliding hole in the near cortex. Ensure perfect fracture reduction and then insert a drill guide. Drill the threaded hole in the far (trans) cortex through the drill guide.

This method ensures that the threaded hole is perfectly in line with the gliding hole.
This is the preferred method.