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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 line and totally within the Volkmann's fragment to achieve interfragmentary compression. If possible, engage the far cortex. Use a washer.

If the thread of the 3.5 mm partially threaded screw would still come to lie on both sides of the fracture, to avoid significant protrusion with a longer screw, a fully threaded screw may be used, overdrilling the anterior tibia to form a 3.5 mm gliding hole.


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Insert the first screw

Drill a hole over the more lateral guide wire, through both fragments, with a 2.7 mm cannulated drill bit. Tap the anterior 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.


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Insert the second screw

Remove the first guide wire.

As a rule, a screw which is 5 mm longer than the measured size must be chosen for the second screw as the more medial portion of even a large Volkmann's fragment is often not deep enough to accommodate the whole of the threaded portion of the screw.

The screw tip may therefore protrude a little posteriorly.

If the thread of the 3.5 mm partially threaded screw would still come to lie on both sides of the fracture, or if you do not want the tip of the screw to protrude into the posterior soft tissues, insert a 3.5 mm fully threaded cannulated screw as a lag screw instead, overdrilling the anterior tibia to form a 3.5 mm gliding hole.