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9Locking of the nail

Proximal locking

Proximal locking

Aiming guides for proximal locking screws are a standard part of intramedullary nailing instruments. These are used as intended.
With proximal fractures, multiple locking screws may be required for adequate stability. Their choice usually depends upon the fracture pattern. For diaphyseal fractures, a single locking screw may be sufficient, if the fracture is length-stable. (Use of an oval (“dynamic”) hole will permit fracture impaction while controlling rotation.) If the fracture is length-unstable, two proximal locking screws should be used, for better maintenance of length.