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

Pitfall: breaking the cortex in diaphyseal bone

Do not advance the countersink too deeply into the cortex: the cortical thickness will determine the depth of countersinking. Excess penetration risks break-through of the screw head when tightened and loss of fixation. Countersinking is, therefore, done by hand and not with a power tool.