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3Realignment of the joint

If realignment of the joint cannot be achieved manually, it may be necessary to attach...

If realignment of the joint cannot be achieved manually, it may be necessary to attach the pre-contoured plate to the middle phalanx first and then use the plate as a lever to bring the joint into anatomic alignment.
The hole for the first screw is drilled just distal to the subchondral plate and the length of the screw hole is measured. Now the 5.0mm locking head screw is inserted and provisionally tightened.

Note: It may be advantageous to prepare the glide holes and their countersinking for the two abaxial transarticular cortex screws prior to applying the plate to ensure that the plate does interfere with their preparation at a later point of time.