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4Insertion of distal metacarpal Schanz screw

The guide is removed and its short sleeve is passed over the first Schanz screw.

A skin incision is then made for the insertion of the second Schanz screw as determined by the separation of the short and long sleeves of the guide. This is necessary as the double pin clamps have a fixed distance between the two holes.

The bone is exposed by blunt dissection and the long shaft is again inserted into direct contact with the bone.

The second Schanz screw is inserted through the long shaft of the parallel drill guide.