With the leg and fluoroscope properly positioned, an incision is made with radiographic guidance over the selected locking hole. Soft tissues are bluntly spread, and the drill is positioned over the locking hole (in line with the fluoroscopic central ray). The drill is then advanced through the near tibial cortex, the locking holes in the nail, and the far tibial cortex. Its position is confirmed radiographically. If correct, screw length is measured, the appropriate screw is inserted, and its proper placement
is confirmed radiographically. Details of this procedure may vary somewhat according to surgeon’s experience and available equipment (e.g. radiolucent drill, hand awl, etc).