Screw selection

Determine the length of the screw with the appropriate depth measuring device.

The chosen 3.5 mm partially threaded cannulated screw must lie with its threads completely beyond the fracture to achieve interfragmentary compression, but should not penetrate the anterior cortex. If the bone is osteoporotic and there is a risk that the head of the screw will sink into the bone, use a washer.


Alternatively, a fully threaded screw may be used with lag effect by overdrilling the hole in the Volkmann's fragment.


Insert first screw

Drill a hole over the more lateral guide wire, through both fragments, with a 2.7 mm cannulated drill bit. Tap the posterior tibial cortex with the 3.5 mm cannulated tap and protection sleeve.

Insert the selected 3.5 mm partially threaded cannulated screw, with a washer if desired.


Insert the second screw

Remove the first guide wire and repeat the process for the second screw.

If the fragment has a large enough proximal extension, a third screw may be used here, or a buttress plate may be applied.

Confirm satisfactory reduction and screw placement with X-ray control.