Screw insertion in neutral mode

Introduction

When non-locking screws are inserted into the middle of a plate hole, it presses the plate straight down onto the bone.

Technique

For one third tubular plates, the universal spring-loaded LC-DCP drill guide with the guide pressed against the bone.

spring-loaded LC-DCP drill guide

For LC-DCP plates, the DCP drill guide with green colar is used.

DCP drill guide

In LCP combi holes, the universal spring-loaded DCP drill guide with pressure against the bone can be used in the non-threaded portion of the hole.

universal spring-loaded DCP drill guide

The hole is drilled through both cortices in the diaphysis.

Drilling

A depth gauge is used to determine the screw length.

If self-tapping screws are used add 2 mm to the screw length so that the portion of the screw in the far cortex is fully threaded.

Determination of screw lenght

The design of the screw head and plate hole allows some angulation of the screw in relation to the plate, eg to avoid neurovascular structures.

Screw angulation

In the diaphysis, cortical screws are used. These may be self-tapping screws, which have tap flutes at the tip. When the screw is fully tightened, the tap flutes should lie outside the bone.

Cortical screws

In metaphyseal bone fully threaded cancellous screws are usually used unless they are acting as a lag screw. The tip remains within the bone.

Metaphyseal screws

The hole is tapped. The tip of the tap should just penetrate the far cortex. Take care to not allow the tap to continue into the soft tissues.

If self-tapping screws are used, this step can be omitted.

Tapping

The screw is inserted and tightened.

Screw insertion