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5Fixation

Now, with the fracture reduced and plate properly positioned, drill eccentrically (load position) for the first screw...

Axial compression with eccentric screw

Now, with the fracture reduced and plate properly positioned, drill eccentrically (load position) for the first screw in the proximal segment. Insert the eccentric screw fully to additionally compress the transverse fracture site.
Remember for oblique fractures to use plate compression “into the axilla” of plate and bone. Use of only an eccentric compression screw may not produce sufficient compression, unless a nearly perfect reduction is present before the screw is tightened. Many surgeons thus prefer to use a device external to the plate to compress more complex fractures like the illustrated C2 pattern.